Ankylosing spondylitis and degenerative lumbar destabilization

Abstract

Introduction: Ankylosing spondylitis is a chronic inflammatory disease that mainly affects the joints of the spine, which tend to weld together, causing a limitation of mobility. As a result there is a loss of flexibility of the spine, being rigid and fused by ossifications that form joints between articulations of the spine, both facet joints and intervertebral discs. It is a frequent disease, especially in the white race (0.5-1% of the population). It usually appears between 20 and 30 years old. The treatment of this pathology comprises NSAIDs at maximum dosage as first line drugs and physical therapy (initial therapy), and in case of non-response, TNFalpha inhibitor drugs can be used, which have shown therapeutic success especially in stages Early. It is associated with different inflammatory lesions, where the compromise can be bone, of the disc, of synovial joints and/or enthesis. The vertebral lesions ultimately lead to the formation of Sindesmófitos and ankylosis.

Objective: To describe a case of bread secondary Hypopituitarism Sheehan syndrome.

Material and methods: Retrospective descriptive study, clinical case presentation.

Results: It presents the case of a female patient of 72 years of age who comes for lumbar pain of 2 months of evolution, without apparent cause, accompanied by edema of inferior limbs and paresthesias, scale of Glasgow 15/15, in the MRI of lumbar column is observed diffuse image at level of L4-L5, mobility and force were conserved. Evolutionally NMR reports Spondylodiscitis at the L4-L5 level. Not to cede the symptomatology with physiotherapist treatment or analgesic. Surgical interventionism was decided by finding a fusion-type lesion at L4-L5 level with vertebral instability, lumbosacral arthrodesis was performed. The histopathological study showed compatible signs of ankylosing spondylitis.

Conclusion: Although Ankylosing spondylitis is more common in males between 20-30 years of age, it should be considered as a differential diagnosis in women in elderly women with low back pain of unspecified etiology, for proper treatment.