Transverse vertebral fracture in osteoporotic aged patients with ankylosing spinal hyperostosis

Object The object of this case series was to report the unstable transverse spinal fracture in osteoporotic ankylosing spinal hyperostosis. Clinical materials and methods We report eight cases from 2001 to 2008, four men and four women, aged 66–85 (Average 76.1). Results We could treat three cases conservatively, but in two cases the treatment was converted to surgery due to a delayed onset of paraparesis. In total, five cases were treated surgically. Surgical procedures were laminectomy with posterior instrumentation. The surgical results were recovery to walking in two, recovery to standing with aid in two, and no gain in one. A loss of reduction occurred in two cases, with ventral displacement appearing to be the cause of the poor result in one. Conclusions The surgery for this situation is troublesome. We should manage the vertebral fracture in ankylosing spinal hyperostosis very carefully; keeping in mind that it might actually be unstable transverse vertebral fracture.