{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:29:19Z","timestamp":1772108959219,"version":"3.50.1"},"reference-count":19,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T00:00:00Z","timestamp":1699142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The purpose of this case report is to describe the case of a patient with ankylosing spinal hyperostosis (ASH) and lumbar spine fracture complicated by ureteral injury mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation followed by the cervical spine fracture. A consecutive analysis and summary of the medical history, radiological documentation, operative procedure, complications, and outcomes were performed. A 59-year-old man presented with abdominal pain three weeks after sustaining a low-energy fall. The performed CT scans demonstrated a three-column fracture at the L3\/L4 level and features of ASH. Additionally, MRI scans demonstrated hyperintense fluid collection within L3\/L4 intervertebral space communicating with both psoas major muscles, mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation. An in situ instrumented lumbar fusion at the L2-L3-L5-S1 levels with implantation vertebral body replacement implant at the L3\/L4 level was performed. Postoperative CT imaging revealed evidence of post-traumatic right ureteral injury. Following urological treatment covering nephrectomy and ureter ligation, the patient was maintained at a 2-year follow-up. After this period, the patient presented again with tetraparesis after sustaining a low-energy fall. The performed CT scans demonstrated a three-column fracture at the C5\/C6 level. The combined anterior and posterior osteosynthesis at the C4-C5-C6-C7 levels was performed. This case report presents the rare clinical constellation regarding the lumbar spine fracture complicated by ureteral injury followed by a cervical spine fracture regarding the same patient. The potential injury of retroperitoneal structures, including the ureter after hyperextensive lumbar spine fracture, should be considered in ASH patients. In this case, one should be aware of the atypical clinical presentation regarding the observed spondylodiscitis- and osteomyelitis-like features.<\/jats:p>","DOI":"10.3390\/jcm12216937","type":"journal-article","created":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T07:35:06Z","timestamp":1699169706000},"page":"6937","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Fracture of the Lumbar Spine Associated with Ureteral Injury Mimicking Spondylodiscitis Followed by Cervical Spine Fracture in Patient with Ankylosing Hyperostosis"],"prefix":"10.3390","volume":"12","author":[{"given":"Micha\u0142","family":"Wo\u017anica","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, 7th Navy Hospital, Polanki 117, 80-305 Gda\u0144sk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Szymon","family":"Kaczor","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, 1st Military Clinical Hospital in Lublin\u2014Branch in E\u0142k, Tadeusza Ko\u015bciuszki 30, 19-300 E\u0142k, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0141ukasz A.","family":"Poniatowski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Dietrich-Bonhoeffer-Klinikum, Salvador-Allende-Stra\u00dfe 30, 17036 Neubrandenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miko\u0142aj","family":"Ra\u017aniak","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mazovian Br\u00f3dno Hospital, Kondratowicza 8, 03-242 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miros\u0142aw","family":"Z\u0105bek","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mazovian Br\u00f3dno Hospital, Kondratowicza 8, 03-242 Warsaw, Poland"},{"name":"Department of Neurosurgery, Centre of Postgraduate Medical Education, Kondratowicza 8, 03-242 Warsaw, Poland"},{"name":"Interventional Neurotherapy Center, Mazovian Br\u00f3dno Hospital, Kondratowicza 8, 03-242 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1097\/BSD.0b013e3181679bcb","article-title":"The management of spinal injuries in patients with ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis: A comparison of treatment methods and clinical outcomes","volume":"22","author":"Whang","year":"2009","journal-title":"J. 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