Leg Paresis Caused by Destructive Discovertebral Lesion in Ankylosing Spondylitis: A Case Report

Abstract

Introduction: Extensive discovertebral destruction is a little-known complication associated with advanced ankylosing spondylitis (AS). These lesions are either inflammatory or traumatic in nature, the latter often associated with deformity, severe back pain, and neurologic sequelae. Therefore, surgical treatment is often recommended in patients with traumatic lesions.

Case Report: A 68-year-old female patient being treated for osteoporosis associated with AS was admitted to our hospital for progressive leg paresis. Computed tomography and magnetic resonance imaging scans revealed widespread destruction of T2-T3 vertebral bodies and intervertebral disc with a resulting posterior column like-pseudarthrosis. Surgery was performed using a posterior approach, combining posterior fixation with screws and rods encompassing C6-T6, and decompression without anterior fusion. Subsequently, solid fusion was achieved, and the patient had a favorable recovery.

Conclusions: Posterior fixation without anterior fusion is a viable operative strategy in patients with extensive discovertebral destruction associated with AS.