title: Combined anterior and posterior surgery for treatment of cervical fracture-dislocation in patients with ankylosing spondylitis.
abstract: OBJECTIVE
  To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondylitis (AS) and the effect of combined anterior and posterior operation.
  
  
  METHODS
  Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on 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 according to Frankel's score. There were 15 cases of Grade III dislocation and 3 cases of Grade II. 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 surgeries. There was certain extent of neurological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a long-term complication in follow-up.
  
  
  CONCLUSIONS
  The study suggests that anterior combined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.
authors.affiliation: Department of Spinal Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
authors.forename: Guo-Hua
authors.initials: GH
authors.lastname: Lv
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
authors.forename: Yi-Jun
authors.initials: YJ
authors.lastname: Kang
authors.forename: Chang
authors.initials: C
authors.lastname: Lu
authors.forename: Ze-Min
authors.initials: ZM
authors.lastname: Ma
authors.forename: You-Wen
authors.initials: YW
authors.lastname: Deng
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013167:Spondylitis, Ankylosing / Q000150:complications*