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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three techniques for measuring spinal mobility, with special reference to ankylosing spondylitis --the spondylometer, the goniometer, and a skin of distraction method--are discussed, and their accuracies and feasibilities compared. The spondylometer was found to be the quickest method, but of limited applicability to certain movements only, the goniometer the most versatile and of acceptable accuracy, and the skin distraction method inaccurate and complicated.
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PMID:Measurement of spinal mobility: a comparison of three methods. 116 37

Twenty-two measurements repeated non-sequentially on each of 10 patients by five observers were undertaken to determine their reliability for routine clinical use. Measurements without significant inter-observer variation or with a coefficient of reliability greater than 0.70 were cervical rotation, cervical lateral flexion, tragus to wall distance, fingertip to floor distance on sagittal and lateral flexion, C7 to iliac crest line distraction and modified Schober index. It is concluded that many of the currently used measurements are either statistically unreliable or clinically unhelpful in mild or moderate ankylosing spondylitis. The most clinically useful were cervical rotation using a protractor, cervical lateral flexion using a goniometer, thoracolumbar flexion as the C7 to iliac crest line distraction, thoracolumbar lateral flexion as the fingertip to floor distance and the modified Schober index.
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PMID:Clinical assessment of ankylosing spondylitis: a study of observer variation in spinal measurements. 199 Dec 13

The radiological features, clinical findings and mortality rates of patients with ankylosing spondylitis complicated by cervical trauma have been reviewed. All patients had long-standing disease and half had sustained their fractures as a result of trivial accidents. There were 19 cervical fractures in 18 patients, which were chalkstick in type and occurred predominantly at the 6th and 7th cervical levels. Ten fractures passed through the upper part of the vertebral body, one through the mid-vertebral body and the final eight were through the disc space. The site of the fracture line was related to neurological outcome. Those patients whose fracture line ran through the disc space had significantly less neurological injury and a much better prognosis. Distraction at the fracture site had some relation to prognosis but horizontal displacement and angulation were not found to be of importance. This study confirms that cervical fracture with neurological complications may follow minor trauma in ankylosing spondylitis. The site of the fracture in relation to the vertebral bodies and discs appears to be of some prognostic relevance and careful radiological assessment of all patients with ankylosing spondylitis and cervical injury should be undertaken.
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PMID:Fracture of the cervical spine in ankylosing spondylitis. 406 39

Six patients were managed with gradual reduction of a deformity of the cervical spine, before operative stabilization, with use of a modified halo cast with adjustable distraction components that allowed the patient to sit and walk while the deformity was being corrected. The distraction components were constructed from the distractors, hinges, and connectors of an Ilizarov apparatus. The diagnoses were atlanto-axial subluxation secondary to rheumatoid arthritis, atlanto-axial rotatory subluxation secondary to juvenile rheumatoid arthritis, post-traumatic atlanto-axial rotatory subluxation, ankylosing spondylitis with an angulated fracture of the seventh cervical vertebra, atlanto-occipital and atlanto-axial subluxation secondary to familial cervical dysplasia, and cervicothoracic kyphosis secondary to laminectomy and radiation for astrocytoma. All of the deformities were corrected initially, but the deformity partially recurred in three patients: in the lower cervical area because of pseudarthrosis in one, and between the occiput and the first cervical vertebra after arthrodesis between the first and second cervical vertebrae in two. Complications included an infection at the site of the halo pin, which led to replacement of the pin (one patient); pressure sores under the body cast (two patients); dislodgment of the halo secondary to a fall, which necessitated reapplication of the halo (one patient); and pneumonia (one patient). Spinal distraction with halo-cast traction is a useful adjunct in the treatment of selected complex cervical and high thoracic deformities. Gradual three-dimensional correction may be obtained in a controlled fashion, while the patient is allowed out of bed to sit and walk.
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PMID:The halo-Ilizarov distraction cast for correction of cervical deformity. Report of six cases. 833 75

Fixed sagittal imbalance of the spine leads to a disabling posture with compensatory hip and knee flexion. The most common causes of fixed sagittal imbalance include degenerative lumbar disease, complications from the use of distraction instrumentation in the lower lumbar spine, ankylosing spondylitis, and posttraumatic kyphosis. Surgical procedures to correct sagittal deformities include the posterior Smith-Petersen osteotomy, pedicle subtraction osteotomy, and posterior vertebral column resection. For complex multiplanar deformities, combined anterior and posterior vertebral column resection may be needed to provide vertebral column shortening and balanced correction in the coronal and sagittal planes. Current reports of these procedures stress the importance of patient selection, radiographic evaluation, and meticulous surgical technique. Complications include excessive blood loss, incomplete correction, wound infection, and pseudarthrosis. Most patients who are treated with these procedures report a high level of satisfaction with the outcome.
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PMID:Role and technique of eggshell osteotomies and vertebral column resections in the treatment of fixed sagittal imbalance. 1695 91

Detection of preradiographic sacroiliitis is important for early diagnosis of ankylosing spondylitis (AS) and related spondyloarthropathies. Magnetic resonance imaging (MRI) is a valuable tool for the diagnosis of sacroiliitis in the early and active stages. The aim of this study is to assess the value of pain provocation tests in detecting early active sacroiliitis. Chronic low-back pain (LBP) patients were recruited and examined by blinded assessors for pain provocation tests: compression, distraction, Gaenslen, Mennel, Patrick, thigh thrust and sacral thrust tests. Patients underwent lumbar and sacroiliac MRI. The percentage of agreement for each pain provocation tests was between 72-95%, and the inter-rater reliability was from moderate to good (kappa, 0.43-0.87). Kappa values ranged from 0.43 to 0.60 with an agreement of 80-95% for clusters of pain provocation tests. As separately evaluated, pain provocation tests did not have favorable accuracy. When evaluated in clusters (out of three and five provocation tests) four positive over five tests on the left side reached an area under the curve 0.693 (95% CI 0.489-0.897), and two positive over three tests reached an AUC 0.697 (95% CI 0.484-0.910). Sacroiliac pain provocation tests had acceptable reliability in early active sacroiliitis; however, the discriminating capacity of these tests is poor. A multi-test regimen of three or five sacroiliac pain provocation tests may improve the accuracy of these tests discriminating sacroiliitis from LBP of mechanical origin. Four out of five selected tests or any of the two out of three selected tests have the highest predictive value.
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PMID:The value of sacroiliac pain provocation tests in early active sacroiliitis. 1845 88

Chance fractures are usually associated with seat belt injuries. Mechanism is always related to flexion-distraction at vertebral level. Double level Chance-type fractures have rarely been reported in published literature. We presented such a fracture at D10 and L3 level in a 38-year-old patient with ankylosing spondylitis. Management was done with posterior decompression and short segment fixation separately.
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PMID:Double level Chance-type fractures of spine in ankylosing spondylitis. 2547 35

Purpose: The aim of this systematic review was to evaluate the effect of immersive and non-immersive interactive virtual reality on pain perception in patients with a clinical pain condition.Methods: The following databases were searched from inception: Medline (Ovid), PsychInfo, CINAHL, Cochrane library and Web of Science. Two reviewers screened reports and extracted the data. A third reviewer acted as an arbiter. Studies were eligible if they were randomized controlled trials, quasi-randomized trials, and uncontrolled trials. Crossover and parallel-group designs were included. Risk of bias was assessed for all included studies.Results: Thirteen clinical studies were included. The majority of studies investigated a sample of participants with chronic pain. Six were controlled trials and seven uncontrolled studies. Findings from controlled research suggest that interactive virtual reality may reduce pain associated with ankylosing spondylitis and post-mastectomy, but results are inconsistent for patients with neck pain. Findings from uncontrolled studies suggest that interactive virtual reality may reduce neuropathic limb pain, and phantom limb pain, but had no effect on nonspecific chronic back pain.Conclusions: There is a need for more rigorous randomized control trials in order to conclude on the effectiveness of the use of virtual reality for the management of pain.Implications for rehabilitationInteractive virtual reality has been increasingly used in the rehabilitation of painful conditions.Interactive virtual reality using exergames may promote distraction from painful exercises and reduce pain post-mastectomy and in patients with ankylosing spondylitis.Interactive virtual representation of limbs may reduce neuropathic and phantom limb pain.
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PMID:The effect of interactive virtual reality on pain perception: a systematic review of clinical studies. 3106 35

The utilization of robotics has been gaining increased popularity in spine surgery. It can be used to assist in pedicle screw insertion when anatomy is complex in deformity surgery, but is also helpful in degenerative spine as it can minimize tissue dissection and fluoroscopy use.1-6 We present an operative video that demonstrates the use of a robotic system (Globus Excelsius GPS, Audubon, Pennsylvania) for thoracic instrumentation in an unstable fracture. The patient we present is a 64-yr-old male who sustained a T8-9 distraction extension fracture after falling down a flight of stairs. His computed tomography (CT) scan showed ossification of the anterior longitudinal ligament making ankylosing spondylitis the likely underlying condition.7,8 His magnetic resonance imaging showed an epidural hematoma extending from T7 to T11. Due to the unstable nature of this fracture and the presence of the hematoma, informed consent was obtained and the patient underwent thoracic pedicle screw fixation from T7 to T11 and laminectomy for hematoma evacuation. A preoperative CT was done for screw trajectory planning. Paraspinal muscle dissection was limited to the hematoma level to allow for laminectomy and evacuation. After registration of the patient to the robotic system using C-arm fluoroscopy, pilot burr holes are drilled using a rigid robotic arm and with optical tracking in real time. This reduces the degrees of freedom and allows for higher precision of screw placement. To the authors' knowledge, this video is the first one to show the utilization of robotics for thoracic instrumentation in an acute fracture.
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PMID:Robot-Assisted Instrumented Fusion of a T8-9 Extension Distraction Fracture and Epidural Hematoma Evacuation: 2-Dimensional Operative Video. 3225 53