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In ankylosing spine there are unique biomechanical conditions which
any spine surgeon has to know. Rules should be obeyed, otherwise the
implanted screw-rod-system will not lead to successful treatment. Often
revision surgery is necessary.
The authors very well describe the systemtic pharmacological therapy
that diminuished inflammation and helped the patient to recover.
But in a spine surgeon's view t...
But in a spine surgeon's view the surgical procedure was inadequate:
An Andersson lesion is a sign of severe instability. This was recognized
by the surgeon because he tried to fix both ends of the vertebral column,
that has the appearance of a "bamboo spine" (shown image b). But he has
chosen a too short, bisegmental instrumentation.
There is a lot of evidence, that this type of instability can't be
restored by this surgical strategy (see literature below).
The surgical principles in Andersson lesion seem to be the same as in
fractures in ankylosing spine.
The persisting postoperative pain can also be explained as a
The therapy of Andersson lesion has to include both: First of all
adequate stabilization and second adequate pharmacological inhibiton of
- Caron T, Bransford R, Nguyen Q et al (2010) Spine fractures in patients
with ankylosing spinal disorders. Spine (Phila Pa 1976) 35:E458-464
- Hitchon PW, From AM, Brenton MD et al (2002) Fractures of the
thoracolumbar spine complicating ankylosing spondylitis. J Neurosurg
A.T. Mameghani, Basel, Switzerland