Distal Pedicle Subtraction Osteotomy for Ankylosing Spondylitis With the Dual Complications of Andersson Lesions and Idiopathic Spinal Cord Hernia: A Rare Case Report

ABSTRACT Background and Importance Ankylosing spondylitis (AS) is a systemic chronic inflammatory disease. Andersson lesion (AL) is a late complication of advanced AS. Idiopathic spinal cord hernia (ISCH) is a rare disorder of the spinal cord. However, according to our literature review, the simulta...

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Main Authors: Junyu Li, Zexi Yang, Xinyu Zhang, Zesen Shang, Hongyu Wu, Danfeng Zheng, Zhuoran Sun, Yongqiang Wang, Yan Zeng, Weishi Li, Miao Yu
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Orthopaedic Surgery
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Online Access:https://doi.org/10.1111/os.14344
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author Junyu Li
Zexi Yang
Xinyu Zhang
Zesen Shang
Hongyu Wu
Danfeng Zheng
Zhuoran Sun
Yongqiang Wang
Yan Zeng
Weishi Li
Miao Yu
author_facet Junyu Li
Zexi Yang
Xinyu Zhang
Zesen Shang
Hongyu Wu
Danfeng Zheng
Zhuoran Sun
Yongqiang Wang
Yan Zeng
Weishi Li
Miao Yu
author_sort Junyu Li
collection DOAJ
description ABSTRACT Background and Importance Ankylosing spondylitis (AS) is a systemic chronic inflammatory disease. Andersson lesion (AL) is a late complication of advanced AS. Idiopathic spinal cord hernia (ISCH) is a rare disorder of the spinal cord. However, according to our literature review, the simultaneous occurrence of AL together with ISCH in a single AS patient had never been reported. Clinical Presentation A 49‐year‐old male reported a 30‐year history of thoracolumbar pain and limited mobility and was diagnosed with AS with dual complications of AL and ICSH. Before correction surgery, physical examination, x‐ray, CT, MRI and Blood HLA‐B27 examination were performed and a series of radiological parameters, including the degree of kyphosis and the T1‐pelvic angle (TPA), were measured. Several days after surgery (Distal PSO was used), we performed examinations to check the patient's physical condition which showed the patient recovered remarkably. CTA was done, indicating that the patient's aorta moved anteriorly with the osteotomy side undamaged. A series of morphological parameters were measured again, including TPA, LL, and TK. CT and MRI were performed again, reflecting significant bone‐to‐bone fusion and successful recovery. The patient relieved the symptoms and regained his daily activities. Conclusions We deepen the understanding of the diagnosis and treatment of AS with rare complications of AL and ISCH. Distal PSO could be an effective option for severe AS patient.
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spelling doaj-art-1f6a66ef577945058b9ab0633a351b212025-08-20T02:18:20ZengWileyOrthopaedic Surgery1757-78531757-78612025-03-0117397197810.1111/os.14344Distal Pedicle Subtraction Osteotomy for Ankylosing Spondylitis With the Dual Complications of Andersson Lesions and Idiopathic Spinal Cord Hernia: A Rare Case ReportJunyu Li0Zexi Yang1Xinyu Zhang2Zesen Shang3Hongyu Wu4Danfeng Zheng5Zhuoran Sun6Yongqiang Wang7Yan Zeng8Weishi Li9Miao Yu10Orthopedic Department Peking University Third Hospital Beijing ChinaOrthopedic Department Beijing Jishuitan Hospital Capital Medical University Beijing ChinaPeking University Health Science Center Beijing ChinaOrthopedic Department Peking University Third Hospital Beijing ChinaPeking University Health Science Center Beijing ChinaPathology Department Peking University Third Hospital Beijing ChinaOrthopedic Department Peking University Third Hospital Beijing ChinaOrthopedic Department Peking University Third Hospital Beijing ChinaOrthopedic Department Peking University Third Hospital Beijing ChinaOrthopedic Department Peking University Third Hospital Beijing ChinaOrthopedic Department Peking University Third Hospital Beijing ChinaABSTRACT Background and Importance Ankylosing spondylitis (AS) is a systemic chronic inflammatory disease. Andersson lesion (AL) is a late complication of advanced AS. Idiopathic spinal cord hernia (ISCH) is a rare disorder of the spinal cord. However, according to our literature review, the simultaneous occurrence of AL together with ISCH in a single AS patient had never been reported. Clinical Presentation A 49‐year‐old male reported a 30‐year history of thoracolumbar pain and limited mobility and was diagnosed with AS with dual complications of AL and ICSH. Before correction surgery, physical examination, x‐ray, CT, MRI and Blood HLA‐B27 examination were performed and a series of radiological parameters, including the degree of kyphosis and the T1‐pelvic angle (TPA), were measured. Several days after surgery (Distal PSO was used), we performed examinations to check the patient's physical condition which showed the patient recovered remarkably. CTA was done, indicating that the patient's aorta moved anteriorly with the osteotomy side undamaged. A series of morphological parameters were measured again, including TPA, LL, and TK. CT and MRI were performed again, reflecting significant bone‐to‐bone fusion and successful recovery. The patient relieved the symptoms and regained his daily activities. Conclusions We deepen the understanding of the diagnosis and treatment of AS with rare complications of AL and ISCH. Distal PSO could be an effective option for severe AS patient.https://doi.org/10.1111/os.14344Andersson lesionankylosing spondylitiscase reportdistal pedicle subtraction osteotomyidiopathic spinal cord hernia
spellingShingle Junyu Li
Zexi Yang
Xinyu Zhang
Zesen Shang
Hongyu Wu
Danfeng Zheng
Zhuoran Sun
Yongqiang Wang
Yan Zeng
Weishi Li
Miao Yu
Distal Pedicle Subtraction Osteotomy for Ankylosing Spondylitis With the Dual Complications of Andersson Lesions and Idiopathic Spinal Cord Hernia: A Rare Case Report
Orthopaedic Surgery
Andersson lesion
ankylosing spondylitis
case report
distal pedicle subtraction osteotomy
idiopathic spinal cord hernia
title Distal Pedicle Subtraction Osteotomy for Ankylosing Spondylitis With the Dual Complications of Andersson Lesions and Idiopathic Spinal Cord Hernia: A Rare Case Report
title_full Distal Pedicle Subtraction Osteotomy for Ankylosing Spondylitis With the Dual Complications of Andersson Lesions and Idiopathic Spinal Cord Hernia: A Rare Case Report
title_fullStr Distal Pedicle Subtraction Osteotomy for Ankylosing Spondylitis With the Dual Complications of Andersson Lesions and Idiopathic Spinal Cord Hernia: A Rare Case Report
title_full_unstemmed Distal Pedicle Subtraction Osteotomy for Ankylosing Spondylitis With the Dual Complications of Andersson Lesions and Idiopathic Spinal Cord Hernia: A Rare Case Report
title_short Distal Pedicle Subtraction Osteotomy for Ankylosing Spondylitis With the Dual Complications of Andersson Lesions and Idiopathic Spinal Cord Hernia: A Rare Case Report
title_sort distal pedicle subtraction osteotomy for ankylosing spondylitis with the dual complications of andersson lesions and idiopathic spinal cord hernia a rare case report
topic Andersson lesion
ankylosing spondylitis
case report
distal pedicle subtraction osteotomy
idiopathic spinal cord hernia
url https://doi.org/10.1111/os.14344
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