Surgical management of ankylosing spondylitis combined with lower cervical spine fractures and dislocations
WANG Lei
SONG Yue-ming
LIU Hao
LIU Li-min
GONG Quan
LI Tao
ZENG Jian-cheng
KONG Qing-quan
Abstract：Objective To explore the clinical characteristics and surgical treatment of lower cervical spine fractures and dislocations combined with ankylosing spondylitis ( AS ).Methods From February 2010 to December 2013, 21 patients with AS combined with spinal fractures were adopted, including 7 patients with lower cervical spine fractures. There were 6 males and 1 female, whose average age was 47.8 years old ( range: 40-52 years ). All the 7 patients underwent surgical treatment, including 1 patient with C5-6 fractures and dislocations and 6 patients with C6-7 fractures and dislocations. Simple anterior interbody fusion and internal ifxation was performed on 1 patient, simple posterior long-segmental ifxation and fusion on 1 patient, and a combined anterior-posterior approach on the other 5 patients.Results All the 7 patients were followed up for a mean period of 18.2 months ( range: 6-34 months ). There was no aggravation of neuronal damage during and after the operation, and primary healing of surgical incisions was achieved in all the patients. Cerebrospinal lfuid leakage was noticed in 1 patient, who recovered after 2 weeks of changing dressing. Internal ifxation loosening was found in 1 patient with C5-6 fractures and dislocations at the 2nd day after the anterior surgery, and a combined anterior-posterior revisional operation was performed immediately. The remarkable improvement of the neuronal function was obtained in 6 patients after the operation, and no obvious improvement in 1 patient ( Frankel grade B preopertively ). Bone fusion was achieved in all the patients, without loosening, breakage or displacement of internal fixation during the follow-up.Conclusions The lower cervical vertebrae is the common location of AS and spinal fractures, usually combined with spinal cord injury ( SCI ). A combined anterior-posterior reduction and posterior long-segmental ifxation and bone graft fusion are 2 satisfactory surgical methods. The aggravation of neuronal damage can be effectively avoided, with complete decompression before ifne reduction.
Keywords：SpondylitisankylosingSpinal fracturesOrthopedic proceduresSurgical proceduresOperativeCervical vertebrae
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 745-750 )