Case Report: Spinal cord herniation associated with ankylosing spondylitis
- 1Department of Spine and Osteopathy, Shenzhen University General Hospital , ,
Abstract
Background: Spinal cord herniation (SCH) is a rare clinical entity characterized by the ventral displacement of the spinal cord through a dural defect. While often classified as idiopathic, SCH associated with ankylosing spondylitis (AS) is exceedingly rare. The pathogenesis in such cases remains unclear, and treatment strategies are not well standardized.
Case presentation: Herein, we report a series of four patients with long-standing ankylosing spondylitis who presented with SCH between August 2018 and August 2021. All patients exhibited severe thoracolumbar kyphosis and restricted spinal mobility. Uniquely, the herniations occurred at the vertebral body level rather than the disc level, and one patient presented with rare multilevel herniations. Two patients underwent pedicle subtraction osteotomy (PSO) with spinal fusion. In both surgical cases, direct dural repair was avoided; stabilization was achieved through indirect cord relaxation via spinal column shortening. Postoperative imaging showed successful kyphosis correction and stabilization of the herniation.
Conclusion: SCH in patients with AS is a distinct entity secondary to inflammatory and biomechanical changes. PSO with fusion is a viable surgical option that addresses both deformity and cord tethering through an indirect mechanism.
Related
- Adalimumab-induced pustular psoriasis successfully treated with tofacitinib in a patient with ankylosing spondylitis: A brief report.
- Sexual Function After Corrective Spinal Osteotomy in Female Patients with Ankylosing Spondylitis: A Retrospective Single-Center Case Series
- Successful extravascular implantable cardioverter defibrillator implantation in a patient with ankylosing spondylitis and severe thoracic deformity: a case report.
- Case Report: Sacrococcygeal teratoma with malignant transformation into mixed adenocarcinoma and squamous cell carcinoma following TNF-α inhibitor therapy for ankylosing spondylitis
- GLP-1 receptor agonist initiation and newly recorded ankylosing spondylitis diagnoses in type 2 diabetes: a target trial emulation
BibTeX
@article{ke2026case,
title = {{Case Report: Spinal cord herniation associated with ankylosing spondylitis}},
author = {Zekai Ke and Chunguang Duan},
journal = {Frontiers in surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1818905},
url = {https://europepmc.org/article/PMC/PMC13720914},
note = {CC BY},
}
RIS
TY - JOUR
TI - Case Report: Spinal cord herniation associated with ankylosing spondylitis
AU - Zekai Ke
AU - Chunguang Duan
PY - 2026
DA - 2026/10/16
JO - Frontiers in surgery
DO - 10.3389/fsurg.2026.1818905
UR - https://europepmc.org/article/PMC/PMC13720914
AB - Background: Spinal cord herniation (SCH) is a rare clinical entity characterized by the ventral displacement of the spinal cord through a dural defect. While often classified as idiopathic, SCH associated with ankylosing spondylitis (AS) is exceedingly rare. The pathogenesis in such cases remains unclear, and treatment strategies are not well standardized. Case presentation: Herein, we report a series of four patients with long-standing ankylosing spondylitis who presented with SCH between August 2018 and August 2021. All patients exhibited severe thoracolumbar kyphosis and restricted spinal mobility. Uniquely, the herniations occurred at the vertebral body level rather than the disc level, and one patient presented with rare multilevel herniations. Two patients underwent pedicle subtraction osteotomy (PSO) with spinal fusion. In both surgical cases, direct dural repair was avoided; stabilization was achieved through indirect cord relaxation via spinal column shortening. Postoperative imaging showed successful kyphosis correction and stabilization of the herniation. Conclusion: SCH in patients with AS is a distinct entity secondary to inflammatory and biomechanical changes. PSO with fusion is a viable surgical option that addresses both deformity and cord tethering through an indirect mechanism.
SN - 2296-875X
ER -