Spinal Cord Injury in Ankylosing Spondylitis

Abstract

<h3>Research Objectives</h3> To study the inpatient rehabilitation outcomes and complication in patient with ankylosing spondylitis (AS) with spinal cord injury. <h3>Design</h3> A case series. <h3>Setting</h3> Inpatient rehabilitation facility. <h3>Participants</h3> 3 patients with an established diagnosis of ankylosing spondylitis who suffered from traumatic spinal cord injury were identified within a 2-year period. <h3>Interventions</h3> None. <h3>Main Outcome Measures</h3> Data on demographics, significant co-morbidities, mechanism of injury (low energy vs high energy), involved vertebrae fracture level, ASIA impairment score (AIS), complications during inpatient rehabilitation (pressure sore, chest complications, pulmonary embolism, deep vein thrombosis, infections) and neurological improvement after inpatient rehabilitation (functional Independence Measure (FIM), upper extremity motor scores (UEMS), lower extremity motor scores (LEMS) were collected. <h3>Results</h3> Our patients suffered traumatic spinal cord injury from a fall from level ground (low energy impact) and involved uniformly fractured the cervical vertebrae. All 3 patients had joint pains that needed analgesia and was dependent on an indwelling catheter for continence during inpatient rehabilitation. In particular, 2 patients needed a prolonged inpatient rehabilitation stay of 247 and 273 days. They suffered from multiple episodes of urine tract infections and immobility related decubitus ulcers. Both had a low FIM efficiency and remained wheelchair bound. <h3>Conclusions</h3> Our retrospective case series corroborated with the known literature that patients with diagnosed ankylosing spondylitis suffered spinal cord injury from low-energy trauma. Patients with ankylosing spondylitis should be advised on adequate fall precautions and avoidance of high risk activities. It provided better understanding of this particular subgroup of patients and their rehabilitation outcomes. (all 3 had severe injury/ complications/ prolonged stay) Additional studies with a larger sample size is needed for better generalisation of results. <h3>Author(s) Disclosures</h3> All authors have no conflicts of interest to declare.