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Review Looks at Injuries in Spinal Disorders

Outcomes discussed for ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis

MONDAY, April 13 (HealthDay News) -- A review of outcomes following spinal injuries in individuals with ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH) suggests appropriate management strategies in these cases, according to research published in the April issue of the Journal of Spinal Disorders & Techniques.

Peter G. Whang, M.D., of Yale University School of Medicine in New Haven, Conn., and colleagues reviewed data from 12 patients with ankylosing spondylitis and 18 with DISH who were treated for spinal injuries, most of which involved the area between C5 and C7.

In the ankylosing spondylitis group, 83.3 percent were treated surgically, most often a posterior decompression/fusion, the researchers report. In the DISH group, 66.7 percent were treated surgically. Both groups had statistically similar outcomes and survivorship, and 81.3 percent of all surviving subjects had excellent or good outcomes. The four deaths among the two groups were thought to be linked to halo-vest use, the authors note.

"Even if it may not be feasible to formulate a definitive treatment protocol from the results of this case series, it is clear from our extensive experience caring for these individuals that there are several important technical considerations that merit further discussion. As both of these diseases are associated with the development of kyphotic deformities, it is essential that the preinjury alignment of the spine be restored to achieve an adequate and hopefully stable reduction of the fracture," Whang and colleagues write.

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