Andersson lesion in Ankylosing Spondylitis with paraparesis: A Case report of 2 patients

Dr Abhijit B Kale; Dr Subhashis Banerjee; Dr Gaurav Waghmare; Dr Gautham Suresh

Volume : IX, Issue : VI, June - 2020

Andersson lesion in Ankylosing Spondylitis with paraparesis: A Case report of 2 patients

Dr Abhijit B Kale, Dr Subhashis Banerjee, Dr Gaurav Waghmare, Dr Gautham Suresh

Abstract :

INTRODUCTION: Andersson lesions(AL) are disco-verteal degenerative lesions in patients with Ankylosing Spondylitis(AS). Though the prevalence is low but patients with AL have high incidence of neurological deficit. Extensive lesions may present with puesodoarthosis and neuro-deficit for which often surgical interventions are necessary . This case report describes the management of 2 such patients treated with long segment posterior instrumentation and fusion with a follow up period of 5 years. CASE REPORT: Both the middle aged patients had a history of long standing AS with positive HLA B27 from late adolescent age, presented with insidious onset of increased intensity of pre-existing back pain and gradual onset paraplegia. Radiographic evaluation revealed disco-verteal degeneration with narrowing of spinal canal at D9-10 (Patient 1) and L1-2 level (patient 2). Both the patients were treated with long segment pedicular screw fixation and decompression. Posterolateral fusion in patient 1 and posterior and anterior fusion in patient 2. RESULT: Complete recovery of neurology and healing was evident by 1 year. On follow up of 5 years both were clinically pain free till the last day of report. No signs of instability were seen in the adjacent segments of the fusion levels. CONCLUSION: Only a few literatures are available mainly in the form of case series for AL. The reason may be due to the low prevalence or due to missed diagnosis owing to lack of clinical suspicion. Studies with increased sample size and high level of evidence such as RCT will help in the formation of proper protocol for management.