Objective To explore the clinical features, diagnosis and treatment of the spinal fracture with ankylosing spondylitis ( AS ). Methods Eighteen patients of spinal fracture with AS from January 2003 to January 2012 were treated in the Third Hospital of Hebei Medical University. Eleven cases were treated surgically with open reduction and internal fixation. Other 7 cases received conservative treatment. Results The mean follow - up time was 30 months excluding a single death due to respiratory failure. One patient treated surgically with L4_5 vertebral fracture was found nonunion after 7 months. Another operation was carried out with replacement of pedicle screw and anterior fixation with bone graft and fracture healing. There was no deterioration at the scope of spinal activity and kyphose deformity in the patients with conservative treatment. Fracture healing was showed in X - ray. There was no looseness or breakage of the internal fixation. And there were 10 in 16 cases with neurological deficit improved with a varying degree one year later. Conclusion Due to its special features, doctors should treat the patients individually, pay close attention to the fracture union and neurological function recovery, conduct the patients with reasonable exercise and achieve satisfactory goals.%目的 探讨强直性脊柱炎合并脊柱骨折的临床特点及诊治方法.方法 选择2003年1月-2012年1月收治的强直性脊柱炎合并脊柱骨折的患者18例.其中行手术治疗11例,非手术治疗7例.结果 除1例颈椎骨折患者因呼吸衰竭死亡外,其余17例均得到随访,平均随访时间30个月.1例L4~5骨折患者术后7个月复查骨折未愈合,经再次手术,后路椎弓根钉更换,前路切开植骨融合,术后骨折愈合.非手术患者脊柱活动范围及后凸畸形程度等较入院前无加重.X线片显示椎体骨折愈合好,手术患者内固定物亦无松动和断裂现象.16例脊髓损伤患者中,10例1年后有不同程度恢复.结论 强直性脊柱炎合并脊柱骨折患者因病情特殊,应根据患者具体情况进行个性化处理.定期复查,密切关注骨折愈合情况及神经恢复情况,进行合理的功能锻炼,达到理想的治疗效果.
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