Ventral fusion of a fracture of the cervical spine in ankylosing spondylitis and struma permagna

Heineck, J.; Bergert, H.; Müller, Michael; Rammelt, S.; Grass, R.; Zwipp, H.; Schneiders, Wolfgang

doi:10.1007/s00113-007-1250-6

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…Because conservative treatment has been correlated with high mortality [1], the current treatment of choice is surgical management, including decompression, fracture reduction, and instrumented fusion. Although a variety of surgical techniques has been described, the best procedure to manage patients with CAS is controversial, with options including the anterior approach (anterior cervical plate) [3,4], posterior approach (lateral mass plating and interspinous wiring of autologous rib graft) [5], lateral mass screws [6], cervical pedicle screws [7], and multilevel posterior stabilization with lateral mass or pedicle screw fixation [8], as well as combinations of the anterior and posterior approaches [1,9-12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Surgical Outcomes of the Posterior and Combined Approaches for Repair of Cervical Fractures in Ankylosing Spondylitis

Luksanapruksa¹,

Millhouse²,

Carlson³

et al. 2019

Asian Spine J

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Study Design Retrospective cohort study. Purpose To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C). Overview of Literature Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results. Methods A single institution database was reviewed for data in the period 1999 to 2015. All CAS patients who underwent posterior or combined instrumented fusion were enrolled. We analyzed demographic data, radiographic results, perioperative complications, and postoperative results. Results Thirty-three patients were enrolled (23 in the P group, 10 in the C group). All patients presented with neck pain after a fall. In the P group, mean operative time was 161.1 minutes (100–327 minutes), and mean estimated blood loss (EBL) was 306.4 mL (50–750 mL). In the C group, 90% of patients underwent a staged procedure, typically with posterior surgery first. Mean EBL was 124 mL (25–337 mL). For posterior surgery, mean EBL was 458.3 mL (400–550 mL). EBL of posterior surgery in the C group was higher but this difference was not significant ( p =0.16). Postoperative complication rate was higher in the C group but this difference was not significant (50% vs. 17.4%, p =0.09). In the follow-up period, no late reoperations were performed. Patients who underwent C surgery had a higher rate of neurological improvement but this difference was not significant ( p =0.57). Conclusions Both P and C provided good clinical results. P surgery had lower EBL, lower postoperative complication rate, and shorter length of stay than C surgery; none of these differences were statistically significant.

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