Cervical Spine in Ankylosing Spondylitis

- See: Spine in AS;

- Disussion:
    - 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;

- Managment:
    - 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.