Management of spinal fractures in patients with ankylosing spondylitis

• Spinal fractures in of ankylosing spondylitis (AS) patients have potentially devastating complications.
• Management of spinal fractures in the setting of AS remains controversial.
• Surgical treatment of spinal fractures related to AS seems to be safe and to improve patient outcomes.
• Prevention is essential in minimizing morbidity of spinal fractures in AS patients.

Ankylosing spondlylitis is a seronegative spondyloarthropathy that primarily affects the spinal column and sacroiliac joints. With disease progression autofusion of the spinal column takes place. This combined with the brittle bone quality make patients prone to fractures and spinal cord injury. The typical fracture pattern is extension type and involves all three columns. These fractures and injuries may involve the craniovertebral junction, the subaxial cervical spine, and the thoracolumbar spine. While at times these fractures are challenging to manage especially when they affect the elderly, there is evidence that supports long segment fixation and fusion. This article presents a narrative review on managing spinal fractures in patients with ankylosing spondylitis.