RESEARCH - Clinical vertebral fractures in patients with ankylosing spondylitis

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J Rheumatol. 2004 Oct;31(10):1981-5.

Clinical vertebral fractures in patients with ankylosing spondylitis.

Vosse D, Feldtkeller E, Erlendsson J, Geusens P, van der Linden S.

Department of Internal Medicine, Division of Rheumatology, University

Hospital Maastricht, Maastricht, The Netherlands. dvo@...

OBJECTIVE: To evaluate the prevalence and characteristics of clinically

confirmed vertebral fractures (CVF) in patients with ankylosing spondylitis

(AS). METHODS: Coordinated by the Ankylosing Spondylitis International

Federation in Germany and in Denmark, a self-administered questionnaire was

sent to all their members about age, diagnosis, disease duration, HLA-B27

status, and history of CVF. Patients who were aware of having had a CVF were

asked to return the questionnaire with additional specification of the

location of CVF, associated trauma, neurological complications, therapy for

these complications, and recovery. We also reviewed available radiographs.

RESULTS: Out of 15,097 questionnaires, 59 patients (0.4%) reporting 66 CVF

returned the complete questionnaire (46 men, 13 women). Mean age at fracture

was 50 +/- 9 years, after a mean duration of symptoms of 26 +/- 11 years.

CVF with wedging or crush or transverse fracture were reported in the

cervical (n = 21, 36%), thoracic (n = 21, 36%), and lumbar spine (n = 16,

27%), with one unspecified. In 37 fractures (56%), patients reported no/low

or medium trauma in relation to the fracture. In 31 fractures (47%),

patients reported neurological complications, occurring mostly without

trauma (n = 11, 35%) or after minimal trauma (n = 7, 23%). Twenty (65%) of

these patients did not have full neurological recovery.

CONCLUSION: We found that 0.4% of patients with AS reported CVF at a mean

age of 50 years, occurring after 2 decades of disease, mainly without trauma

or after minimal trauma, with frequent neurological complications mostly

followed by incomplete neurological recovery.

PMID: 15468363

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