24057Array
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    [TITRE_TRAVAIL] => Array
        (
            [0] => TRANS-DISCAL FRACTURE IN ANKYLOSING SPONDYLARTHRITIS
        )

    [etablissement] => Array
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            [0] => Institut kassab-servuce adulte
        )

    [nom] => Array
        (
            [0] => Ben mohamed
        )

    [prenom] => Array
        (
            [0] => Oussama
        )

    [email] => Array
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            [0] => oussama_benmohamed@hotmail.fr
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    [telephone] => Array
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            [0] => 55187314
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    [auteurs] => Array
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            [0] => 
 
Nom prénom / Name Surname: Chedi saadi
Email: Saadi.9@hotmail.fe
Hôpital / Hospital: Kassab

 
Nom prénom / Name Surname: Mehdi meddeb
Email: Meddeb.3@hotmail.fr
Hôpital / Hospital: Kassab/service adulte

 
Nom prénom / Name Surname: Mondher mestiri
Email: Mestiri@hotmail.fr
Hôpital / Hospital: Kassab/service adulte

        )

    [mots_cles] => Array
        (
            [0] => Spondylarthite ankylosante;
Case report;

        )

    [event-id] => Array
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            [0] => 3663
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            [0] => 1
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            [0] => none
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    [user_email] => Array
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            [0] => oussama_benmohamed@hotmail.fr
        )

    [specialite] => Array
        (
            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Introductio: Ankylosing spondylitis: chronic inflammatory disease which mainly affects the spine and sacroiliac joints. Causes pain, stiffness and progressive thoracolumbar deformity. The development of vertebral or discovertebral lesions, including trans-discal fracture (TDF), is a well-known complication in patients with AS. Methodologie: We report 4 observations of patients treated in our department for FTD on SPA. All patients were men. The average age was 51.6 years. All patients had been followed for SPA for more than a decade. The main reason for consultation was back pain and low back pain. Only one patient consulted for walking problems and vesico-sphincter problems. The floors reached were between D10 and L3. The neurological examination was normal in the majority of patients except one patient.Two patients were operated on for FTD via a posterior approach using a long construct. A second anterior approach was planned for these patients but was not carried out for various reasons. Only one patient did not undergo surgery. His fracture consolidated spontaneously. Discussion: Trans-discal fracture can result from inflammation or a (stress) fracture of the completely ankylosed spine. The mechanical constraints of this rigid spine prevent consolidation and cause pseudarthrosis. In the literature, cervical locations are very predominant. Thoracolumbar involvement is only found in half of the cases. The diagnosis of FTD is established on conventional radiography, CT and MRI. MRI is less sensitive than CT to visualize the fracture line. MRI: visualize the fracture line within all the stabilizing structures of the spine and especially allows diagnosis of neurological complications. Results: The management of FTD in patients with AS is controversial, and there is no consensus regarding management. Untreated, this fracture generally progresses to pseudarthrosis. Some authors advocate orthopedic treatment. Other studies: Conservative treatment has been associated with disappointing outcomes, such as worsening deformity, risk of nonunion, and risk of neurological worsening. Anterior and posterior surgical instrumentation and circumferential arthrodesis are considered the principle management in FTD. Conclusion: Trans-discal fractures remain a rare and serious complication in patients with SPA and an ankylosed spine, which can lead to neurological complications and mechanical pain .
        )

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