The CT Image Changes in Ankylosing Spondylitis from Fracture to Andersson Lesions: A Case Report and Literature Review
Authors Bai LL, Du JP, Xue XK, Hao DJ, Wang WT
Received 15 September 2020
Accepted for publication 30 October 2020
Published 20 November 2020 Volume 2020:15 Pages 2227—2230
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Prof. Dr. Zhi-Ying Wu
Lu Lu Bai,1,2,* Jin Peng Du,1 Xu Kai Xue,1,* Ding Jun Hao,1 Wen Tao Wang1
1Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi 710054, People’s Republic of China; 2Graduate School, Xi’an Medical University, Xi’an, Shaanxi, 710021, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wen Tao Wang
Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi 710054, People’s Republic of China
Background: Ankylosing spondylitis with Andersson lesions is not rare, but its potential pathogenesis and natural course remain unclear.
Case Description: We describe a case of CT image changes in ankylosing spondylitis from fracture to Andersson lesions. A 40-year-old man with a 23-year history of ankylosing spondylitis presented with acute back pain after a slight fall, and the CT showed a T12 fracture; the patient refused surgery for 12 months. The process from fracture to Andersson lesions was characterized by CT, including the subsequent interbody bone graft with internal fixation and successful bone fusion at the last follow-up. Histopathologic analysis showed degenerative fibrocartilage tissue calcification, necrotic intervertebral disc tissue, fibrovascular hyperplasia, and focal accumulation of inflammatory cells.
Conclusion: Aseptic inflammation and persistent instability caused by a fracture contributed in the course from fracture to Andersson lesions in ankylosing spondylitis. CT can accurately track the pathological process, and interbody fusion via the posterior pedicle lateral approach can achieve satisfactory effectiveness, good fusion and kyphosis correction.
Keywords: ankylosing spondylitis, Andersson lesions, CT