- See: Spine in AS;
- patients with ankylosing spondylitis are prone to C-spine fracture following minor trauma;
- acute neck pain in a patient with ankylosing spondylitis is usually caused by a fracture through the ankylosed spine;
- site of involvement is most commonly near cervicothoracic junction (or C6-7);
- the fracture may extend thru the disc space or may extend thru all columns;
- there may be significant change in neck alignment;
- epidural hematoma may contribute to spinal cord injury;
- initial stabilization of C-spine w/ halo traction is recommended;
- immobilize C-spine in prefracture position;
- anatomic reduction of C-spine may cause catastrophic neurologic injury;
- in some cases, the traction needs to be placed w/ the patient in the semi-sitting position w/ traction directed upwards;
- most of these fractures will heal with sufficient immobilization;
Management of cervical spine injuries in patients with ankylosing spondylitis.
KN Detwiler et al. J. Neurosurgery. Vol 72. 1990. p 210-215.
Fractures of the spine in ankylosing spondylitis: Diagnosis, treatment, and complications.
G Graham and PK Van Peteghem. Spine. Vol 14. 1989. p 803-807.
Cervicothoracic Extension Osteotomy for Chin-on-Chest Deformity in Ankylosing Spondylitis.
Original Text by Clifford R. Wheeless, III, MD.