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Lessons learned from cervical pseudoarthrosis in ankylosing spondylitis

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Abstract

This case report illustrates three learning points about cervical fractures in ankylosing spondylitis, and it highlights the need to manage these patients with the neck initially stabilised in flexion. We describe a case of cervical pseudoarthrosis that is a rare occurrence after fracture of the cervical spine with ankylosing spondylitis. This went undetected until the development of myelopathic symptoms many months later. The neck was initially stabilised in flexion using tongs, and then slowly extended before anterior and posterior fixation was performed. The myelopathic symptoms resolved, and the patient had a good result at 18 months. We conclude that any increased movement of the spine after trauma in ankylosing spondylitis must be considered suspect and fully investigated.

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References

  1. Aebi M, Zuber K, Marchesi D (1991) Treatment of cervical spine injuries with anterior plating. Indications, techniques and results. Spine 16 [Suppl 3]:38–45

    Google Scholar 

  2. Albertsen AM, Jurik AG (1996) Posttraumatic spinal osteolysis in ankylosing spondylitis as part of pseudoarthrosis. A case report. Acta Radiol 37:98–100

    Google Scholar 

  3. Althoff B, Goldie IF (1980) Cervical collars in rheumatoid atlanto-axial subluxation: A radiographic comparison. Ann Rheum Dis 39:485–489

    Google Scholar 

  4. Amamilo SC (1989) Fractures of the cervical spine in patients with ankylosing spondylitis. Orthop Rev 18:339–344

    Google Scholar 

  5. Andersson O (1939) Röntgenbilden vid sponylarthritis ankylopoetica. Nord Med Tidskv 14:2000–2002

    Google Scholar 

  6. Broom MJ, Raycroft JF (1988) Complications of fractures of the cervical spine in ankylosing spondylitis. Spine 13:763–766

    Google Scholar 

  7. Cawley MID, Chalmers TM, Kellgren JH, Ball J (1972) Destructive lesions of vertebral bodies in ankylosing spondylitis. Ann Rheum Dis 31:345–358

    Google Scholar 

  8. Curran C, Dietrich AM, Bowman MJ, Ginn-Pease ME, King DR, Kosnik E (1995) Pediatric cervical spine immobilization: Achieving neutral position? J Trauma 39:729–732

    Google Scholar 

  9. Deburge A, Guigui P, Ouahes M, Barre E (1996) Cervical pseudarthrosis in ankylosing spondylitis. A case report. Spine 21:2801–2805

    Google Scholar 

  10. Fang D, leong JCY, Ho EKW, Chan FL (1988) Spinal pseudarthrosis in ankylosing spondylitis. J Bone Joint Surg Br 70:443–447

    Google Scholar 

  11. Finkelstein JA, Chapman JR, Mirza S (1999) Occult vertebral fractures in ankylosing spondylitis. Spinal Cord 37:444–447

    Google Scholar 

  12. Furst SR, Kindynis P, Gundry C, Haghighi P, Sartoris DJ, Resnick D (1990) Pseudopseudarthrosis in a patient with ankylosing spondylitis. J Rheumatol 17:258–262

    Google Scholar 

  13. Goffin J, van Loon J, Van Calenbergh F, Plets C (1995) Long-term results after anterior fusion and osteosynthetic stabilisation for fractures and/or dislocations of the cervical spine. J Spinal Disord 8:500–508

    Google Scholar 

  14. Graham B, Van Peteghem PK (1989) Fractures of the spine in ankylosing spondylitis: Diagnosis, treatment and complications. Spine 14:803–807

    CAS  PubMed  Google Scholar 

  15. Henriques T, Olerud C, Bergman A, Jonsson H (2004) Distractive flexion injuries of the subaxial cervical spine treated with anterior plate alone. J Spinal Disord Tech 17:1–7

    Google Scholar 

  16. Hunter T, Dubo HIC (1983) Spinal fractures complicating ankylosing spondylitis. A long-term follow up study. Arthritis Rheum 26:751–759

    CAS  PubMed  Google Scholar 

  17. Lawrence JS (1963) The prevalence of arthritis. Br J Clin Pract 17:699

    Google Scholar 

  18. Lifeso RM, Colucci MA (2000) Anterior fusion for rotationally unstable cervical spinal fractures. Spine 25:2028–2034

    Google Scholar 

  19. Murray GC, Persellin RH (1981) Cervical fracture complicating ankylosing spondylitis. A report of eight cases and review of the literature. Am J Med 70:1033–1041

    Article  CAS  PubMed  Google Scholar 

  20. Papadopoulos MC, Chakrabouty A, Waldron G, Bell BA (1999) Exacerbating cervical spine injury by applying a hard collar. BMJ 319:171–172

    Google Scholar 

  21. Pettersson T, Laasonen L, Leirisalo-Repo M, Tervahartiala P (1996) Spinal pseudoarthrosis complicating ankylosing spondylitis: A report of two patients. Br J Rheumatol 35:1319–1323

    Google Scholar 

  22. Podolsky SM, Hoffman JR, Pietrafesa CA (1983) Neurological complications following immobilization of cervical spine fractures in a patient with ankylosing spondylitis. Ann Emerg Med 12:578–580

    Google Scholar 

  23. Rasker JJ, Prevo RL, Lanting PJH (1995) Spondylodiscitis in ankylosing spondylitis. Inflammation or trauma? Scand J Rheumatol 25:52–57

    Google Scholar 

  24. Taggard DA, Traynelis VC (2000) Management of cervical spinal fractures in ankylosing spondylitis with posterior fixation. Spine 25:2035–2039

    Google Scholar 

  25. Vaverka M, Hrabalek L (2001) Injuries of the cervical spine in patients with ankylosing spondylitis. Rozhl Chir 80:5–8

    Google Scholar 

  26. Wu PC, Fang D, Ho EK, Leong JC (1988) The pathogenesis of extensive discovertebral destruction in ankylosing spondylitis. Clin Orthop 230:154–161

    Google Scholar 

  27. Young JS, Cheshire DJE, Pierce JA, Vivian JM (1977) Cervical ankylosis with acute spinal cord injury. Paraplegia 15:133–139

    Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Royal Hampshire County Hospital, Romsey Road, Winchester, Hampshire, England, SO22 5DG, UK

    J. Mountney, A. J. Murphy & J. L. Fowler

  2. 84 Havendale Hedge End, Southampton, England, SO30 0FF, UK

    J. Mountney

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  1. J. Mountney
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  2. A. J. Murphy
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  3. J. L. Fowler
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Correspondence to J. Mountney.

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Mountney, J., Murphy, A.J. & Fowler, J.L. Lessons learned from cervical pseudoarthrosis in ankylosing spondylitis. Eur Spine J 14, 689–693 (2005). https://doi.org/10.1007/s00586-004-0742-0

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  • DOI: https://doi.org/10.1007/s00586-004-0742-0

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