Minimally invasive stabilization of the fractured ankylosed spine: a comparative case series study

• Published in: Journal of spine surgery (Hong Kong) Vol. 4; no. 2; pp. 168 - 172
• Main Authors: Brooks, Francis, Rackham, Matthew, Williams, Ben, Roy, Deb, Lee, Yu Chao, Selby, Michael
• Format: Journal Article
• Language: English
• Published: China AME Publishing Company 01.06.2018
• Subjects: Original Study; spinal fractures; Ankylosing spondylitis (AS); diffuse idiopathic skeletal hyperostosis (DISH); minimally invasive surgery (MIS)
• ISSN: 2414-469X; 2414-4630
• DOI: 10.21037/jss.2018.05.01

To compare the outcome of minimally invasive fracture stabilization to traditional open methods in the thoracolumbar region in patients with an ankylosing disorder of the spine. A prospective, ethics-approved database (Spine Tango) at a tertiary referral center was retrospectively reviewed for results of surgery on fractures of the ankylosed thoracolumbar spine. These were then split by surgical technique into two cohorts: minimally invasive surgical fixation (MIS group) or standard open surgery (open group). We identified 17 patients who presented with fractures in an ankylosed spine from 2010 to 2017. MIS fixation was performed on 10 and open surgery and fixation on 7. Average age in the MIS group was older than the traditional cohort. There was no difference in the average number of levels stabilized (open =6.9, MIS =7). There was a shorter duration in the operative time and a significant difference in blood loss in favor of the MIS group (P=0.00079). Radiation exposure time and dose were significantly higher in the MIS group (P=0.006). There were no cases of non-union, implant malposition or failure in either group. Two significant complications occurred with the death of one patient in the MIS group, and one death in the open group. The MIS technique for fractures of the ankylosed spine has shown an acceptable complication rate and good results comparable to open surgery for a high-risk patient population.