Spinal injury with spinal ankylosing disorders as a primary cause of death: report of two cases
Dublin Core
Title
Spinal injury with spinal ankylosing disorders as a primary cause of death: report of two cases
Subject
Spine ankylosing disorders, Hemothorax, Hemorrhagic shock
Description
Background Spinal ankylosing disorders (SADs) refer to a group of conditions resulting in spontaneous or postsurgi-
cal ossification and fusion of the spinal segments. The spine becomes increasingly susceptible to injury over time such
that even low-energy trauma can cause a spinal injury. We report two cases of SADs, associated with massive thoracic
hemorrhage.
Case presentation The first patient was an 85-year-old male, who suffered from a vehicular crash. He was diagnosed
with a fracture of the first lumbar vertebra, accompanied by SADs. Intubation was required, and thoracic drainage
tubes were inserted. The patient underwent a massive transfusion and thoracotomy with packing. Despite prompt
treatment, the hemorrhage from the vertebral fracture was uncontrolled, and the patient died 180 min after the
injury.
The second case features an 88-year-old male who fell from a height. He was diagnosed with flail chest, hemothorax,
pneumothorax, and a fracture of the eighth thoracic vertebra with SADs. After intubation, four thoracic drainage
tubes were placed, and a massive transfusion was conducted. He died after 3 days due to hypoxemia secondary to
persistent bleeding of the vertebral fracture for 24 h.
Conclusions The patients died of persistent thoracic hemorrhage, and the sources of bleeding were the fracture
site of the spine fractures. Controlling spinal hemorrhage is difficult due to the absence of a bleeding artery, which
is managed via trans-arterial embolization. This report emphasized that fracture of SADs could be a fatal disease that
requires prompt intervention.
cal ossification and fusion of the spinal segments. The spine becomes increasingly susceptible to injury over time such
that even low-energy trauma can cause a spinal injury. We report two cases of SADs, associated with massive thoracic
hemorrhage.
Case presentation The first patient was an 85-year-old male, who suffered from a vehicular crash. He was diagnosed
with a fracture of the first lumbar vertebra, accompanied by SADs. Intubation was required, and thoracic drainage
tubes were inserted. The patient underwent a massive transfusion and thoracotomy with packing. Despite prompt
treatment, the hemorrhage from the vertebral fracture was uncontrolled, and the patient died 180 min after the
injury.
The second case features an 88-year-old male who fell from a height. He was diagnosed with flail chest, hemothorax,
pneumothorax, and a fracture of the eighth thoracic vertebra with SADs. After intubation, four thoracic drainage
tubes were placed, and a massive transfusion was conducted. He died after 3 days due to hypoxemia secondary to
persistent bleeding of the vertebral fracture for 24 h.
Conclusions The patients died of persistent thoracic hemorrhage, and the sources of bleeding were the fracture
site of the spine fractures. Controlling spinal hemorrhage is difficult due to the absence of a bleeding artery, which
is managed via trans-arterial embolization. This report emphasized that fracture of SADs could be a fatal disease that
requires prompt intervention.
Creator
Takahito Miyake1*, Hideshi Okada1,2, Norihide Kanda1
, Yosuke Mizuno1
, Kodai Suzuki1
, Tomoaki Doi1
,
Takahiro Yoshida1
, Shozo Yoshida1,3 and Shinji Ogura1,2
, Yosuke Mizuno1
, Kodai Suzuki1
, Tomoaki Doi1
,
Takahiro Yoshida1
, Shozo Yoshida1,3 and Shinji Ogura1,2
Source
https://doi.org/10.1186/s12245-023-00488-y
Date
2023
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Takahito Miyake1*, Hideshi Okada1,2, Norihide Kanda1
, Yosuke Mizuno1
, Kodai Suzuki1
, Tomoaki Doi1
,
Takahiro Yoshida1
, Shozo Yoshida1,3 and Shinji Ogura1,2, “Spinal injury with spinal ankylosing disorders as a primary cause of death: report of two cases,” Repository Horizon University Indonesia, accessed April 26, 2026, https://repository.horizon.ac.id/items/show/12117.