Axis fracture in ankylosing spondylitis: case report

Ankylosing spondylitis is a chronic inflammatory disease that results in the slow progressive transformation of the normal spine into a rigid and brittle tube containing the normal neural elements. This pathological condition predisposes the patient to fractures of this structure and a potential for neurological damage greater than that of the normal population. We present a spontaneous fracture of the C1-C2 complex through the base of the dens, with impending neurological deficits in such a patient. We have reviewed the pertinent literature and emphasized several points relative to the management of similar patients.