A Case Report of Neurologically Unstable Fracture of the Lumbosacral Spine in a Patient with Ankylosing Spondylitis



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    Introduction: Fracture/dislocation is uncommonly reported in ankylosing spondylitis involving the lumbosacral spine.

    Clinical Picture: We report an 18-month follow-up of a case of neurologically unstable traumatic fracture of the lumbosacral spine in ankylosing spondylitis.

    Treatment/Outcome: Posterior decompression, alar-transverse fusion and instrumentation were performed. Anterior diskectomy and fusion were done 6 weeks later. There was solid bony fusion on follow-up and the patient had improvement of 2 Frankel grades and was able to ambulate.

    Conclusion: Combined approaches and longer fixations to stabilise the spine may be required. In the lumbosacral spine, this poses a problem vis-à-vis limited levels of fixation in the sacrum.

    Ankylosing spondylitis is associated with progressive ossification of the spinal ligaments and ankylosing of the facet joints leading to a totally stiff spine. It is often associated with osteoporosis due to chronic inflammation and disuse.

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