Chalk-stick fracture in ankylosing spondylitis

Excerpt

A 49-year-old man came to the emergency department, because of back pain after a fall from his own height. Due to a history of ankylosing spondylitis (AS), his back had already been painful and stiff, though the pain had abruptly worsened since the fall. On examination, he had normal vital signs and no evident internal organ or nervous system injury. However, his kyphotic spine was moderately tender, particularly at the thoracolumbar area. Plain radiographs (Fig. 1a, b) revealed complete sacroiliac and spinal ankylosis except for the T9-T10 space, which, instead, seemed slightly widened (arrow). To rule out a spinal injury, a computed tomography (CT) was performed. The 3D reconstruction of the CT (Fig. 1c) revealed a spinal fracture through the T9-T10 intervertebral disc (arrow) up to the posterior vertebral elements completely dissecting the spine (chalk-stick fracture). The patient was prescribed braces and advised to remain at bed rest. In the following weeks, his back pain gradually improved and he resumed his prior activity.

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