Neurologic complications following immobilization of cervical spine fracture in a patient with ankylosing spondylitis.
Axial traction is widely recommended for stabilization of cervical spine fractures. This procedure may be inappropriate and even dangerous in patients with long-standing ankylosing spondylitis (AS). We present the case of an 80-year-old woman with AS who fell at home and suffered an unstable large C5-C6 fracture/dislocation associated with left-sided weakness and decreased sensation. Medical treatment included placing her neck in a neutral position, despite her preference for neck flexion. This procedure increased her pain and paresthesias; the complications decreased, but did not entirely resolve, when the patient resumed a semi-flexed position. This patient's neurologic sequelae may have been exacerbated by attempts to stabilize her neck in a neutral position. Standard stabilization recommendations should be appropriately altered in some patients with cervical spine AS.
D000368:Aged; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000209:etiology; D006801:Humans; D010292:Paresthesia / Q000209:etiology*; D011187:Posture; D013117:Spinal Cord Compression / Q000209:etiology; D013124:Spinal Injuries / Q000150:complications* / Q000209:etiology; D013167:Spondylitis, Ankylosing / Q000150:complications*; D014143:Traction / Q000009:adverse effects*