scholarly journals Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis

Medicine ◽  
2015 ◽  
Vol 94 (44) ◽  
pp. e1663 ◽  
Author(s):  
Jun Ma ◽  
Ce Wang ◽  
Xuhui Zhou ◽  
Shengyuan Zhou ◽  
Lianshun Jia
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Surgical Therapy ◽  
Spine Fracture ◽  
Cervical Spine Fracture

Surgical treatment of cervical spine fractures in ankylosing spondylitis patients: posterior stabilization using intraoperative CT scanner-based navigation

2020 ◽  
Vol 99 (5) ◽  
pp. 212-218
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Ct Imaging ◽  
Spine Fracture ◽  
Cervical Spine Fracture ◽  
Posterior Stabilization ◽  
Visceral Injury ◽  
Intraoperative Ct ◽  
Screw Insertion ◽  
Spinal Navigation

Introduction: The authors analyzed a series of ankylosing spondylitis patients with cervical spine fracture undergoing posterior stabilization using spinal navigation based on intraoperative CT imaging. The purpose of this study was to evaluate the accuracy and safety of navigated posterior stabilization and to analyze the adequacy of this method for treatment of fractures in ankylosed cervical spine. Methods: Prospectively collected clinical data, together with radiological documentation of a series of 8 consecutive patients with 9 cervical spine fracture were included in the analysis. The evaluation of screw insertion accuracy based on postoperative CT imaging, description of instrumentation- related complications and evaluation of morphological and clinical results were the subjects of interest. Results: Of the 66 implants inserted in all cervical levels and in upper thoracic spine, only 3 screws (4.5%) did not meet the criteria of anatomically correct insertion. Neither screw malposition nor any other intraoperative events were complicated by any neural, vascular or visceral injury. Thus we did not find a reason to change implant position intraoperatively or during the postoperative period. The quality of intraoperative CT imaging in our group of patients was sufficient for reliable trajectory planning and implant insertion in all segments, irrespective of the habitus, positioning method and comorbidities. In addition to stabilization of the fracture, the posterior approach also allows reducing preoperative kyphotic position of the cervical spine. In all patients, we achieved a stable situation with complete bone fusion of the anterior part of the spinal column and lateral masses at one year follow-up. Conclusion: Spinal navigation based on intraoperative CT imaging has proven to be a reliable and safe method of stabilizing cervical spine with ankylosing spondylitis. The strategy of posterior stabilization seems to be a suitable method providing high primary stability and the conditions for a subsequent high fusion rate.

scholarly journals Surgical Treatment of Cervical Spine Fracture in a Patient with Ankylosing Spondylitis

2011 ◽  
pp. 8-11
Author(s):  
Sergey Kolesov ◽  
◽  
Maksim Sazhnev ◽  
Stepan Kudryakov ◽  
Aleksandr Prokhorov ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Ankylosing Spondylitis ◽  
Spine Fracture ◽  
Cervical Spine Fracture

scholarly journals Upper Cervical Spine Fracture-Dislocation in Patients With Ankylosing Spondylitis: Application of Halo Vest Before and During Posterior Surgery

2021 ◽  
Author(s):  
Haisong Yang ◽  
Yuling Sun ◽  
Liang Wang ◽  
Chunyan Gao ◽  
Fengbin Yu ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Spine Fracture ◽  
Fracture Dislocation ◽  
Cervical Spine Fracture ◽  
Upper Cervical Spine ◽  
Halo Vest ◽  
Posterior Surgery ◽  
Upper Cervical

Abstract Background It is a challenge to reduce and immobilize the broken “bamboo spine”, especially for the upper cervical spine, in patients with ankylosing spondylitis (AS) before and during posterior surgery. Methods We retrospectively analyzed the case histories, operations, neurologic outcomes, follow-up data, and imaging records of 17 patients with AS and upper cervical spine fracture-dislocation who underwent surgical treatment in three clinical spine center from 2010 to 2019. A halo vest was used to reduce and immobilize fractured spinal column ends. The neurological injury was evaluated using the American Spinal Injury Association (ASIA) impairment scale score and Japanese Orthopaedic Association (JOA) score before and after operation. Complications and time of bone fusion were recorded. Results Fourteen patients achieved closed anatomical reduction after halo vest application. No displacement in fracture ends and loss of reduction occurred after prone position. No patient presented with secondary neurological deterioration. All patients was performed posterior surgery. The surgery improved the ASIA grade in all patients (P < 0.001). The mean JOA score also increased significantly at last follow-up compared to preoperation (14.5 ± 2.3 vs. 9.2 ± 2.4, P < 0.01). No severe complication and death occurred. All patients reached solid bony fusion at 12-month follow-up. Conclusions Use of a halo vest before and during the operation is safe and effective in patients with AS who develop upper cervical spine fracture-dislocation. This technique makes positioning, awake nasoendotracheal intubation, nursing, and the operation more convenient. It can also provide satisfactory reduction and rigid immobilization and prevent secondary neurologic deterioration. .

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