Multidetector computed tomography of cervical spine fractures in ankylosing spondylitis

2004 ◽  
Vol 45 (7) ◽  
pp. 751-759 ◽  
Author(s):  
M. P. Koivikko ◽  
M. J. Kiuru ◽  
S. K. Koskinen
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Multidetector Computed Tomography ◽  
Spine Fractures ◽  
Cervical Spine Fractures

scholarly journals A treatment algorithm for the management of cervical spine fractures and deformity in patients with ankylosing spondylitis

2008 ◽  
Vol 24 (1) ◽  
pp. E11 ◽  
Author(s):  
Adam S. Kanter ◽  
Michael Y. Wang ◽  
Praveen V. Mummaneni
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Problem Solving ◽  
Surgical Management ◽  
Treatment Algorithm ◽  
Clinical Problem ◽  
Spine Fractures ◽  
Clinical Problem Solving ◽  
Bone Fusion ◽  
Cervical Spine Fractures

Object Patients with ankylosing spondylitis (AS) who present with cervical spine fractures represent a unique challenge to spine surgeons. These injuries often result in neurological deficits that necessitate early and aggressive surgical management with posterior and/or anterior fixation. The authors introduce a clinical problem-solving algorithm to assist in the surgical management of instability and deformity in this exigent patient population. Methods Thirteen patients with AS and fractures of the cervical spine were radiographically evaluated to determine if spinal realignment was obtainable with cervical manipulation or traction. Seven patients had flexible deformities that were stabilized with either anterior or posterior fixation only, and 6 patients had fixed deformities and required circumferential anterior–posterior instrumentation. All patients were observed for neurological outcome, radiographic evidence of bone fusion, and complications. Results With the use of the authors' treatment algorithm, all patients were able to achieve satisfactory spinal realignment and bone fusion; 92% of patients achieved postoperative stability or improvement in Nurick and modified Japanese Orthopaedic Association scale scores. One patient experienced neurological deterioration following surgery, and 1 patient died at an acute rehabilitative facility following discharge. Conclusions Patients with AS are highly susceptible to extensive neurological injury and spinal deformity after sustaining cervical fractures from even minor traumatic forces. These injuries are uniquely complex in nature and require considerable scrutiny and aggressive surgical management to optimize spinal stability and functional outcomes. The authors' clinical problem-solving algorithm will assist spine surgeons in providing optimal care in this difficult population.

scholarly journals Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis

2008 ◽  
Vol 2 (1) ◽  
Author(s):  
Christoph-E Heyde ◽  
Johannes K Fakler ◽  
Erik Hasenboehler ◽  
Philip F Stahel ◽  
Thilo John ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Spine Fractures ◽  
Cervical Spine Fractures

Mediastinal hematoma secondary to syndesmophyte fracture in ankylosing spondylitis

Trauma ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 237-239
Author(s):  
Tarik Wasfie ◽  
Scott Kreitzberg ◽  
Peter Rydesky
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Current Literature ◽  
Spine Fractures ◽  
Rheumatoid Disease ◽  
Severe Osteoporosis ◽  
Mediastinal Hematoma ◽  
Posterior Mediastinal ◽  
Cervical Spine Fractures

Ankylosing spondylitis is an inflammatory rheumatoid disease with severe osteoporosis affecting the spine with a tendency to fracture. Cervical spine fractures resulting in posterior mediastinal hematoma are rare. We present a patient with widened mediastinum secondary to fracture of a cervical ankylosing spondylitis and discuss its presentation and the current literature on the disease.

Cervical spine fractures in ankylosing spondylitis: MR findings

2002 ◽  
Vol 9 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Ivan Pedrosa ◽  
Manuela Jorquera ◽  
Ramiro Mendez ◽  
Beatriz Cabeza
Keyword(s):  
Cervical Spine ◽  
Ankylosing Spondylitis ◽  
Spine Fractures ◽  
Cervical Spine Fractures

scholarly journals Cervical Computed Tomography Angiography Rarely Leads to Intervention in Patients With Cervical Spine Fractures

2019 ◽  
Vol 10 (8) ◽  
pp. 992-997
Author(s):  
Conor John Dunn ◽  
Stuart Changoor ◽  
Kimona Issa ◽  
Jeffrey Moore ◽  
Nancy J. Moontasri ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Computed Tomography Angiography ◽  
Neurological Deficits ◽  
Cervical Region ◽  
Trauma Patients ◽  
Spine Fractures ◽  
Cervical Fractures ◽  
Cervical Spine Fractures ◽  
The Impact

Study Design: Retrospective cohort study. Objectives: To evaluate the impact of computed tomography angiography (CTA) in the management of trauma patients with cervical spine fractures by identifying high-risk patients for vertebral artery injury (VAI), and evaluating how frequently patients undergo subsequent surgical/procedural intervention as a result of these findings. Methods: All trauma patients with cervical spine fractures who underwent CTA of the head and neck at our institution between January 2013 and October 2017 were identified. Patients were indicated for CTA according to our institutional protocol based on the modified Denver criteria, and included patients with cervical fractures on scout CT. Those with positive VAI were noted, along with their fracture location, and presence or absence of neurological deficit on physical examination. Statistical analysis was performed and odds ratios were calculated comparing the relationship of cervical spine fracture with presence of VAI. Results: A total of 144 patients were included in our study. Of those, 25 patients (17.4%) were found to have VAI. Two patients (1.4%) with VAI underwent subsequent surgical/procedural intervention. Of the 25 cervical fractures with a VAI, 20 (80%), were found to involve the upper cervical region (4.2 OR, 95% CI 1.5-12.0; P = .007). Of the 25 who had a VAI, 9 were unable to undergo reliable neurologic examination. Of the remaining 16 patients, 5 (31.3%) had motor or sensory deficits localized to the side of the VAI, with no other attributable etiology. Conclusions: Cervical spine fractures located in the region of the C1-C3 vertebrae were more likely to have an associated VAI on CTA. VAI should also be considered in cervical trauma patients who present with neurological deficits not clearly explained by other pathology. Despite a finding of VAI, patients rarely underwent subsequent surgical or procedural intervention.

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