La pseudoartrosis espinal es una complicación infrecuente de la espondilitis anquilosante de larga evolución, si bien es la más importante desde el punto de vista biomecánico. Generalmente se manifiesta con dolor incapacitante, deformidad y en ocasiones, déficit neurológico. En el diagnóstico de estos pacientes influye de manera decisiva la sospecha clínica ya que los hallazgos tanto en radiografía convencional como en resonancia magnética (R.M.) pueden ser indistinguibles de los de una espondilitis infecciosa.
Se presentan dos casos de pseudoartrosis espinal en pacientes con espondilitis anquilosante de larga evolución que debutaron con clínica de compresión medular. Se discuten los hallazgos radiológicos y la actitud terapéutica.
Spinal pseudoarthrosis, though infrequent, is the most important biomechanical complication of longstanding ankylosing spondylitis. It may often resuIt in disabling back pain, deformity and, occasionally, in neurological deficit. The appropriate diagnosis depends on clinical suspicion as both magnetic resonance and plain film findings can often be mistaken for an infectious diskitis.
We present two cases of spinal pseudoarthrosis in two patients with long-standing ankylosing spondylitis who presented with compressive myelopathy. The radiologic findings and the therapeutic options are discussed.
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