The Clinical Study On The Characteristics Of Cervical Vertebral Fracture With Other Vertebral Fracture In Patients With Ankylosing Spondylitis

Object:To study the clinical characteristics of cervical vertebral fracture with other vertebral fracture in patients with ankylosing spondylitis,and to provide reference for clinical diagnosis and reduce misdiagnosis.Method:Cases in this study were selected from patients with ankylosing spondylitis who received surgical treatment in the department of spinal surgery of China-Japan Union Hospital of Jilin University from January 2008 to October 2018.During the study,32 patients with cervical spine fracture of ankylosing spondylitis are selected.Among them,the other parts of the cervical spine fracture merge vertebral fractures in 8 cases(occurred in 3 cases of thoracic spine,lumbar spine occurred in 1 case,occur in the thoracic lumbar segment 4 cases).During the same period,there were 986 cases of cervical vertebral fractures without ankylosing spondylitis,among which 175 cases were cervical vertebral fractures combined with vertebral body fractures in other parts.The mean age and incidence of cervical fractures with vertebral body fractures in other locations were compared between patients with ankylosing spondylitis and patients without ankylosing spondylitis(incidence = number of cervical vertebral fracture with other vertebral fracture/number of cervical fractures).Eight cases of cervical vertebral fracture combined with vertebral body fracture in other parts of ankylosing spondylitis were statistically analyzed,and the clinical characteristics and the possibility of aggravated nerve injury in 2 cases of patients with occult fracture were analyzed.Result:1.The age of patients in cervical vertebral fracture with other vertebral fracture was 54.5±9.4 years,and that of patients without ankylosing spondylitis was 45.1±12.8 years.T test was performed and t=4.617 and P<0.001 were obtained.There was a statistical difference in the age of disease between the two groups(P<0.05).2.The incidence of cervical vertebral fracture with other vertebral fracture in patients with ankylosing spondylitis was 40.63%,and that of patients without ankylosing spondylitis was 15.52%.The incidence of cervical vertebral fracture with other vertebral fracture in patients with ankylosing spondylitis was higher than that in patients without ankylosing spondylitis,and the difference was statistically significant(P<0.05).3.Among the 8 cases of cervical vertebral fracture with other vertebral fracture of ankylosing spondylitis,cervical vertebral fracture mostly occurred in C6 and C7,among which C6 fracture accounted for 50% and C7 87.5%.Among vertebral body fractures combined with other parts,T12 and L1 mostly occur at the junction of thoracolumbar vertebrae,among which T12 fractures account for 50% and L1 for 50%.4.Among the 32 patients with cervical vertebral fractures in ankylosing spondylitis,2 patients were associated with thoracolumbar occult fractures,and the incidence of occult fractures was 6.25%,among which the incidence of aggravated nerve injury caused by occult multiple fractures was 50%.Conclusion:1.Patients with cervical vertebral fracture with other vertebral fracture of ankylosing spondylitis have a higher incidence age.The incidence of cervical vertebral fracture with other vertebral fracture in patients with ankylosing spondylitis was higher than that in patients without ankylosing spondylitis.2.In patients with cervical vertebral fracture with other vertebral fracture in other parts of ankylosing spondylitis,cervical vertebral fracture mostly occurs in lower cervical C6 and C7 segments,while fractures combined with other parts mostly occur in T12 and L1 segments at the junction of thoracolumbar vertebrae.3.Patients with cervical vertebral fracture of ankylosing spondylitis have the possibility of occult fracture,and the delayed diagnosis of occult fracture may aggravate the nerve injury.Patients with cervical vertebral fracture of ankylosing spondylitis should pay attention to check whether occult fracture occurs,so as to avoid missed diagnosis.