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Related Experiment Videos

Lessons learned from cervical pseudoarthrosis in ankylosing spondylitis.

J Mountney1, A J Murphy, J L Fowler

  • 1Department of Orthopaedic Surgery, Royal Hampshire County Hospital, Romsey Road, Winchester, Hampshire SO22 5DG, England, UK. jm84@jmountney.freeserve.co.uk

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|March 25, 2005
PubMed
Summary

Cervical fractures in ankylosing spondylitis require initial neck stabilization in flexion. Early detection and management of cervical pseudoarthrosis are crucial to prevent myelopathy.

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Rheumatology

Background:

  • Ankylosing spondylitis (AS) patients are at high risk for cervical spine fractures.
  • Cervical fractures in AS can lead to severe complications, including pseudoarthrosis and myelopathy.
  • Delayed diagnosis of cervical spine injuries in AS can result in poor outcomes.

Observation:

  • A rare case of cervical pseudoarthrosis after a cervical spine fracture in an ankylosing spondylitis patient is presented.
  • The pseudoarthrosis went undetected for months, leading to the development of myelopathic symptoms.
  • Initial management involved stabilizing the neck in flexion using tongs.

Findings:

  • The patient underwent sequential anterior and posterior fixation after initial flexion stabilization.

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  • Myelopathic symptoms resolved post-operatively.
  • A good clinical outcome was achieved at 18 months follow-up.

    • Implications:

    • Cervical fractures in ankylosing spondylitis necessitate careful evaluation and management.
    • Initial neck stabilization in flexion is critical for these patients.
    • Any increased spinal mobility after trauma in AS patients should be thoroughly investigated to rule out occult injuries like pseudoarthrosis.