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Cervical Spine in Ankylosing Spondylitis

(see also: 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;

References