TREATMENT FOR PSEUDOARTHROSIS IN ANKYLOSED THORACOLUMBAR SPINE ASSOCIATED WITH BEKHTEREV'S DISEASE

Abstract

Ankylosed spine fracture associated with Bekhterev's disease is a severe injury of the musculoskeletal system. Complex clinical and instrumental examination methods allow detecting such injuries to provide necessary treatment. Otherwise, the fracture nonunion and spine pseudoarthrosis may develop despite the increased osteogenous properties of bone tissue at Bekhterev's disease. This entails a deformation aggravation and a persistent pain syndrome, which, as a rule, is mistaken for basic process worsening. Successful treatment of spine pseudoarthrosis is possible only with a firm fixation of pathologically mobile level and a fusion with a bone graft. The most effective fixation technique in patients with ankylosed spine is a transpedicular fixation, which not only provides a level immobility, but in case of need corrects or normalizes axial deformations of the spine. Even in stable condition the fusion is necessary and preferable in ventral spine, to provide a reliable formation of bone tissue which will close a pseudoarthrosis. Due to the ankylosis of costovertebral junction a thoracotomy is a difficult surgical procedure. Ventral fusion can be performed endoscopically, which provides surgical aggression reduction and better conditions for postoperative rehabilitation of patients with this severe pathology.