Chalk-Stick Fracture in Ankylosing Spondylitis: A Case Report of Cervical Spine Injury Following Minor Trauma.

We describe the case of a 74-year-old male with ankylosing spondylitis (AS) who presented to the Emergency Department for evaluation of acutely worsened left-sided weakness following a fall from standing. Computed tomography (CT) and magnetic resonance imaging (MRI) of his cervical spine revealed a chalk-stick fracture of C5-C7, which required surgical intervention. Chalk-stick fractures are rare, typically occurring in patients with AS, and often occurring from low-energy mechanisms. In the acute setting, providers should maintain a low threshold for obtaining CT or MRI imaging to evaluate spinal injury in patients with AS.

Concurrently Occurring Spinal Cord Cross-Section and Aortic Injury After a Chalk-Stick Fracture and Dislocation in Patient with Ankylosing Spondylitis: Clinical Image.

A 74-year-old woman with ankylosing spondylitis presented with back pain and complete paraplegia after a fall. A radiologic finding of a bamboo spine, a characteristic feature of ankylosing spondylitis, was observed on computed tomography, along with a fracture-dislocation involving T10 and T11 (chalk-stick fracture) and compression of the descending thoracic aorta due to the caudal bony column. The patient underwent an open reduction and T8-L3 posterior fusion in the operating room. A complete cross-section of the spinal cord was observed during surgery. Post operation, a decrease in blood pressure led to a thoracotomy and thoracic endovascular aortic repair due to a crack in the descending aorta wall. Thoracolumbar fracture-dislocations, particularly in patients with ankylosing spondylitis, are characterized by instability and can be further complicated by concurrent vascular and spinal cord injuries. It is crucial therefore to recognize the potential for vascular and spinal cord injuries early on in such cases.

Spontaneous Chalk-Stick Fracture in Ankylosing Spondylitis: A Case Report.

Ankylosing spondylitis (AS) is an inflammatory disease affecting mainly the sacroiliac joints and the spine. In long-standing disease, the fused spine of AS patients is susceptible to spinal fractures, even after low impact trauma. We present a 61-year-old man with long-standing AS who presented with anterior and posterior longitudinal ligament rupture and T12 and L1 vertebral endplates fractures (a so called "chalk-stick fracture") without reporting any prior trauma and discuss relevant issues.