Cervical spine fractures in ankylosing spondylitis: MR findings

The purpose of this study is to evaluate the MR findings in patients with long-term ankylosing spondylitis (AS) and acute cervical spine fractures.

The magnetic resonance imaging (MRI) studies of five patients with AS and acute cervical spine fractures were retrospectively reviewed for the presence of cervical spine instability, spinal cord compression, and epidural hematoma.

Spinal fractures were unstable in all five patients. Three patients had neurological symptoms and abnormal signal within the spinal cord. All patients with neurological deficits had epidural hematomas posterior to the dural sac.

MRI is useful for assessment of the integrity of intervertebral disks and spinal ligaments and, therefore, of the instability of the spinal fracture. MRI is mandatory in patients with neurological symptoms, especially in those with a symptom-free interval and those with neurological deterioration after established spinal cord injury, when suspicion for epidural hematoma is high.