New approach to cervical flexion deformity in ankylosing spondylitis. Case report.

Abstract:

:The treatment of cervical fixed flexion deformity in ankylosing spondylitis presents a challenging problem that is traditionally managed by a corrective cervicothoracic osteotomy. The authors report a new approach to this problem that involves performing a two-level osteotomy at the level of maximum spinal curvature, thereby achieving complete anatomical correction in a one-stage procedure. This 48-year-old woman with ankylosing spondylitis presented with a 30-year history of progressive neck deformity that left her unable to see ahead and caused her to experience difficulty eating, drinking, and breathing on exertion. On examination, she exhibited a 90 degrees fixed flexion deformity of the cervical spine, which was maximum at C-4; this was confirmed on imaging studies. A two-level osteotomy was performed at C3-4 and C4-5 around the area of maximum spinal curvature, and the deformity was corrected by extending the head on its axis of rotation through the uncovertebral joints. The spine was stabilized using a Ransford loop. An excellent anatomical position was achieved, as was complete correction of the deformity. A two-level midcervical osteotomy performed at the level of maximum spinal curvature in ankylosing spondylitis enables complete correction of severe fixed flexion deformity in a single procedure. Preservation of the uncovertebral joints allows smooth and safe correction of the deformity about their axis of rotation.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Duff SE,Grundy PL,Gill SS

doi

10.3171/spi.2000.93.2.0283

subject

Has Abstract

pub_date

2000-10-01 00:00:00

pages

283-6

issue

2 Suppl

eissn

0022-3085

issn

1933-0693

journal_volume

93

pub_type

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