Loading…
Spinal injury in ankylosing spondylitis
Indications for imaging of the cervical spine Glasgow coma score 1 m or at least five stairs, axial load to head, high speed or rollover motor vehicle crash, ejection from a vehicle, collision between motorised recreational vehicles, bicycle collision) >65 years of age Injured >48 hours earlie...
Saved in:
Published in: | BMJ (Online) 2014-06, Vol.348 (jun16 2), p.g3849-g3849 |
---|---|
Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | Indications for imaging of the cervical spine Glasgow coma score 1 m or at least five stairs, axial load to head, high speed or rollover motor vehicle crash, ejection from a vehicle, collision between motorised recreational vehicles, bicycle collision) >65 years of age Injured >48 hours earlier or re-attendance with the same injury Pre-existing vertebral anatomical abnormalities (such as ankylosing spondylitis, rheumatoid arthritis, spinal stenosis, or previous cervical surgery) Box 2: Criteria for the use of computed tomography in cervical injury Glasgow coma score 7/10) Patient has significantly reduced range of neck movement (cannot actively rotate the neck 45° in both directions) Recently revised National Institute for Health and Care Excellence guidelines for computed tomography in head trauma also recommend urgent computed tomography imaging of the cervical spine in adults with head injury who are over 65 years, have sustained a dangerous mechanism of injury (as in box 1), or have a focal peripheral neurological deficit or paraesthesia in the upper or lower limbs. 3 3. Patients with ankylosing spondylitis do not always hit their head when falling backwards because of the pre-existing kyphotic spinal deformity, and when attempting to get up, the head often recoils forwards owing to the kyphosis. Because the bone is osteoporotic, the fracture pattern can look like a flexion injury as part of the vertebral body collapses. Patient outcome The day after hospital admission, the patient underwent surgery with open reduction and internal fixation of the fracture-dislocation using both anterior and posterior stabilisatio |
---|---|
ISSN: | 0959-8138 1756-1833 1756-1833 |
DOI: | 10.1136/bmj.g3849 |