[Combined anterior and posterior approach for cervical fracture-dislocation with ankylosing spondylitis].
OBJECTIVE
To discuss the pathological characteristics of cervical spinal fracture of ankylosing spondylitis (AS), and surgical effect by combined anterior and posterior operation.


METHODS
Eighteen AS patients with traumatic cervical fracture-dislocation were treated from January 2000 to January 2006. The symptom duration of AS was 14.5 years in average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D in Frankel's score. All patients underwent surgical procedures by combined anterior and posterior approach.


RESULTS
There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-anterior procedures. Seven patients had one stage operation and 11 cases underwent two stage. There were some extent neurological improvement in 14 incompletely paraplegic patients, no improvement in 4 complete paraplegia patients. The follow-up period was 21.2 months in average and the bone fusion was 3.6 months. There were 4 complications during perioperative period and 1 in long term follow-up.


CONCLUSIONS
The study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is the reasonable surgical strategy in the treatment of cervical spinal fracture-dislocation with AS.
Lü
Guo-hua
GH
Department of Spinal Surgery, Second Xiangya Hospital, Central Southern University, Changsha 410011, China. gh_lv@2118.cn
Wang
Bing
B
Li
Jing
J
Kang
Yi-jun
YJ
Lu
Chang
C
Ma
Ze-min
ZM
Deng
You-wen
YW
D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000150:complications / Q000601:surgery; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000473:pathology; D016896:Treatment Outcome