TRAUMATIC SPINAL-CORD INJURY COMPLICATING ANKYLOSING-SPONDYLITIS

The aim of this paper is to review the incidence and characteristics f ound in traumatic spinal cord injury (SCI) occurring in patients with long-standing ankylosing spondylitis (AS). The incidence of patients w ith traumatic SCI admitted to our unit from January 1984 to February 1 996 was 2% (15 out of 893). They were all men with a mean age of 56 ye ars. Most frequently the etiology of the lesion was a motor vehicle ac cident and the injury was mainly due to a hyperextension mechanism. Ac ute spinal fracture occurred in 13 patients, all involving the cervica l region. No fracture was observed in two patients with thoracic neuro logical level. Three patients presented with an interval free period o f neurological symptoms in whom a spinal epidural hematoma was visuali zed with magnetic resonance imaging. On admission eight patients were diagnosed as having complete SCI and the other seven an incomplete SCI . In the acute phase, respiratory complications were most frequent, ca using six patients to die. Treatment was conservative in 14 patients. Multidisciplinary management of these patients should be implemented i n an institution equipped with both a Spinal Injury Unit and an Intens ive Care Unit.