Abstract
Background
Patients suffering from ankylosing spondylitis are prone to injuries of the cervical spine even with minor trauma. Although the fractures are markedly unstable, nonsurgical treatment using a halo-thoracic plaster or jacket is a common approach.
Methods
We present three patients with cervicothoracic fractures of the ankylosed spine to describe problems and complications inherent in this type of treatment. In two, pin track infections and pin protrusion through the skull occurred, leading in one case to an intracerebral hemorrhage. In the third patient, the halo had to be removed after 8 months, just early enough to prevent the pins from cutting through.
Results
One patient required craniotomy. The second one could be resolved by local revision. In the third case, the fracture eventually united after using a stiff collar for 2 years.
Conclusion
Halo treatment for cervical spine fracture in patients with ankylosing spondylitis is a challenging task for orthopedic surgeons and neurosurgeons.
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References
Broom MJ, Raycroft JF (1988) Complications of fractures of the cervical spine in ankylosing spondylitis. Spine 13:763–766
Cruickshank B (1971) Pathology of ankylosing spondylitis. Clin Orthop 74:43–58
Dashti R, Gencosmanoglu BE, Hanci M, Uzan M, Sarioglu AC (2000) Management of cervical spinal fractures in patients with ankylosing spondylitis: report of three cases. Eur J Orthop 10:137–140
Detwiler KN, Loftus CM, Godersky JC, Menezes AH (1990) Management of cervical spine injuries in patients with ankylosing spondylitis. J Neurosurg 72:210–215
Fox MW, Onofrio BM, Kilgore JE (1993) Neurological complications of ankylosing spondylitis. J Neurosurg 78:871–878
Graham B, Van Peteghem PK (1989) Fractures of the spine in ankylosing spondylitis. Diagnosis, treatment, and complications. Spine 14:803–807
Grisolia A, Bell RL, Peltier LF (1967) Fractures and dislocations of the spine complicating ankylosing spondylitis. A report of six cases. J Bone Joint Surg Am 49:339–344
Kameyama O, Ogawa K, Suga T, Nakamura T (1999) Asymptomatic brain abscess as a complication of halo orthosis: report of a case and review of the literature. J Orthop Sci 4:39–41
Mehdian SM, Freeman BJ, Licina P (1999) Cervical osteotomy for ankylosing spondylitis: an innovative variation on an existing technique. Eur Spine J 8:505–509
Metz-Stavenhagen P, Krebs S, Meier O (2001) Cervical fractures in ankylosing spondylitis (in German). Orthopade 30:925–931
Müller EJ, Wick M, Muhr G (1998) Subdural abscess as a complication of halo fixator (in German). Unfallchirurg 101:655–657
Papagelopoulos PJ, Sapkas GS, Kateros KT, Papadakis SA, Vlamis JA, Falagas ME (2001) Halo pin intracranial penetration and epidural abscess in a patient with a previous cranioplasty: case report and review of the literature. Spine 26:E463–E467
Schulze W, Esenwein SA, Muller EJ, Russe O, Muhr G (2001) Complications in the use of the halo fixator (in German). Zentralbl Neurochir 62:2–9
Taggard DA, Traynelis VC (2000) Management of cervical spinal fractures in ankylosing spondylitis with posterior fixation. Spine 25:2035–2039
Vertullo CJ, Duke PF, Askin GN (1997) Pin-site complications of the halo thoracic brace with routine pin re-tightening. Spine 22:2514–2516
Weinstein PR, Karpman RR, Gall EP, Pitt M (1982) Spinal cord injury, spinal fracture, and spinal stenosis in ankylosing spondylitis. J Neurosurg 57:609–616
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Schröder, J., Liljenqvist, U., Greiner, C. et al. Complications of halo treatment for cervical spine injuries in patients with ankylosing spondylitis – report of three cases. Arch Orthop Trauma Surg 123, 112–114 (2003). https://doi.org/10.1007/s00402-003-0488-x
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DOI: https://doi.org/10.1007/s00402-003-0488-x