Clinical Interventions in Aging (Nov 2020)
The CT Image Changes in Ankylosing Spondylitis from Fracture to Andersson Lesions: A Case Report and Literature Review
Abstract
Lu Lu Bai,1,2,* Jin Peng Du,1 Xu Kai Xue,1,* Ding Jun Hao,1 Wen Tao Wang1 1Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi 710054, People’s Republic of China; 2Graduate School, Xi’an Medical University, Xi’an, Shaanxi, 710021, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wen Tao WangDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi 710054, People’s Republic of ChinaTel/Fax +86-29-87800002Email [email protected]: Ankylosing spondylitis with Andersson lesions is not rare, but its potential pathogenesis and natural course remain unclear.Case Description: We describe a case of CT image changes in ankylosing spondylitis from fracture to Andersson lesions. A 40-year-old man with a 23-year history of ankylosing spondylitis presented with acute back pain after a slight fall, and the CT showed a T12 fracture; the patient refused surgery for 12 months. The process from fracture to Andersson lesions was characterized by CT, including the subsequent interbody bone graft with internal fixation and successful bone fusion at the last follow-up. Histopathologic analysis showed degenerative fibrocartilage tissue calcification, necrotic intervertebral disc tissue, fibrovascular hyperplasia, and focal accumulation of inflammatory cells.Conclusion: Aseptic inflammation and persistent instability caused by a fracture contributed in the course from fracture to Andersson lesions in ankylosing spondylitis. CT can accurately track the pathological process, and interbody fusion via the posterior pedicle lateral approach can achieve satisfactory effectiveness, good fusion and kyphosis correction.Keywords: ankylosing spondylitis, Andersson lesions, CT
