Conus Medullaris Syndrome Due to Missed Thoracolumbar Spinal Fracture in a Patient with Ankylosing Spondylitis who Underwent Hip Surgery [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-72368 | DOI: 10.5152/TJAR.2019.72368  

Conus Medullaris Syndrome Due to Missed Thoracolumbar Spinal Fracture in a Patient with Ankylosing Spondylitis who Underwent Hip Surgery

Ki Tae Jung1, Keum Young So1, Bo Hyun Jang2, Sang Hun Kim1
1Department of Anaesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea
2Department of Anaesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Republic of Korea

Ankylosing spondylitis (AS) is vulnerable to fracture, and the missed diagnosis can lead to neurological deterioration. Herein, we present the conus medullaris syndrome due to aggravation of the missed spinal fracture in an 85-year-old woman with AS who underwent hip surgery. She underwent osteosynthesis in a supine position with supports under her shoulders and head due to spine deformity with AS, but was fully supine without supports after surgery. She showed complete paraplegia at postoperative 12 h. The re-reading radiological imaging showed the missed spinal fracture, of which the deteriorated dislocation was revealed on the re-examined radiological evaluation. This deterioration was not recovered ultimately despite an emergent surgery. A thorough preoperative assessment is essential to prevent the missed diagnosis of spinal fracture and minimise deterioration due to its dislocation, with specific spine precaution during transport, transfer and positioning.

Keywords: Ankylosing spondylitis, intramedullary fracture fixation, preoperative assessment, spinal cord compression, spinal fractures




Corresponding Author: Sang Hun Kim, South Korea


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