Combined anterior and posterior surgery for treatment of cervical fracture-dislocation in patients with ankylosing spondylitis.
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.
Lv
Guo-Hua
GH
Department of Spinal Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Wang
Bing
B
Kang
Yi-Jun
YJ
Lu
Chang
C
Ma
Ze-Min
ZM
Deng
You-Wen
YW
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*