Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report

Jianxiong Wu; Yongchun Xiao; Hongsheng Lin; Zhisheng Ji; Guowei Zhang

doi:doi:10.11648/j.js.20241201.12

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Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report

Jianxiong Wu, Yongchun Xiao, Hongsheng Lin, Zhisheng Ji, Guowei Zhang^*

Published in Journal of Surgery (Volume 12, Issue 1)

Received: 30 January 2024 Accepted: 18 February 2024 Published: 29 February 2024

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Abstract

Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease that affects the sacroiliac joints and surrounding joints. It is a seronegative spondyloarthritis that invades connective tissue. Managing cervical spine fractures in patients with AS is particularly challenging due to the severity of the deformity and the instability of the fracture. Cervical spine fracture combined with spinal cord injury is the leading cause of death and is strongly correlated with in-hospital mortality in patients with ankylosing spondylitis. There have been limited reports on the revision of cervical spine fractures after internal fixation in patients with AS. The case report is about a patient who is a 34-year-old man who underwent emergency surgery at a local hospital for a cervical spine fracture resulting from a car accident. A postoperative review revealed that the anterior internal fixation was detached, leading to a revision surgery being performed according to the patient's actual condition. Unfortunately, the internal fixation became dislodged fol-lowing the initial surgery, exacerbating the patient's condi-tion and leading to the development of pneumonia. In order to prevent the need for revision surgery, it is crucial to carefully evaluate and determine the most suitable surgical approach for patients with cervical spine fractures and spinal cord injury before proceeding with the initial surgery.

Published in	Journal of Surgery (Volume 12, Issue 1)
DOI	10.11648/j.js.20241201.12
Page(s)	5-10
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Ankylosing Spondylitis, Cervical Spine, Dislocation, Fracture, Revision

References

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[2]	HUNTER T, DUBO H. Spinal fractures complicating ankylosing spondylitis [J]. Ann Intern Med, 1978, 88(4): 546-9.
[3]	GARG K, RAFIQ R, MISHRA S, et al. Cervical Spine Fracture with Extreme Dislocation in a Patient with Ankylosing Spondylitis: A Case Report and Systematic Review of the Literature [J]. Neurol India, 2022, 70(Supplement): S296-S301.
[4]	KANDREGULA S, BIRK H S, SAVARDEKAR A, et al. Spinal Fractures in Ankylosing Spondylitis: Patterns, Management, and Complications in the United States - Analysis of Latest Nationwide Inpatient Sample Data [J]. Neurospine, 2021, 18(4): 786-97.
[5]	VERLA T, XU D S, DAVIS M J, et al. Failure in Cervical Spinal Fusion and Current Management Modalities [J]. Semin Plast Surg, 2021, 35(1): 10-3.
[6]	LUKASIEWICZ A M, BOHL D D, VARTHI A G, et al. Spinal Fracture in Patients With Ankylosing Spondylitis: Cohort Definition, Distribution of Injuries, and Hospital Outcomes [J]. Spine (Phila Pa 1976), 2016, 41(3): 191-6.
[7]	LONGO U G, LOPPINI M, PETRILLO S, et al. Management of cervical fractures in ankylosing spondylitis: anterior, posterior or combined approach? [J]. Br Med Bull, 2015, 115(1): 57-66.
[8]	MA J, WANG C, ZHOU X, et al. Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis [J]. Medicine (Baltimore), 2015, 94(44): e1663.
[9]	TAGGARD D A, TRAYNELIS V C. Management of cervical spinal fractures in ankylosing spondylitis with posterior fixation [J]. Spine (Phila Pa 1976), 2000, 25(16): 2035-9.
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[11]	GOVINDARAJAN V, BRYANT J P, PEREZ-ROMAN R J, et al. The role of an anterior approach in the treatment of ankylosing spondylitis-associated cervical fractures: a systematic review and meta-analysis [J]. Neurosurg Focus, 2021, 51(4): E9.
[12]	FELTELIUS N, HEDENSTROM H, HILLERDAL G, et al. Pulmonary involvement in ankylosing spondylitis [J]. Ann Rheum Dis, 1986, 45(9): 736-40.
[13]	COOPER P R, COHEN A, ROSIELLO A, et al. Posterior stabilization of cervical spine fractures and subluxations using plates and screws [J]. Neurosurgery, 1988, 23(3): 300-6.
[14]	EXNER G, BOTEL U, KLUGER P, et al. Treatment of fracture and complication of cervical spine with ankylosing spondylitis [J]. Spinal Cord, 1998, 36(6): 377-9.
[15]	EINSIEDEL T, SCHMELZ A, ARAND M, et al. Injuries of the cervical spine in patients with ankylosing spondylitis: experience at two trauma centers [J]. J Neurosurg Spine, 2006, 5(1): 33-45.
[16]	CORNEFJORD M, ALEMANY M, OLERUD C. Posterior fixation of subaxial cervical spine fractures in patients with ankylosing spondylitis [J]. Eur Spine J, 2005, 14(4): 401-8.
[17]	DUHEM-TONNELLE V, DUHEM R, ALLAOUI M, et al. [Fracture luxation of the cervical spine in patients with ankylosing spondylitis: six cases] [J]. Neurochirurgie, 2008, 54(1): 46-52.
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APA Style

Wu, J., Xiao, Y., Lin, H., Ji, Z., Zhang, G. (2024). Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report. Journal of Surgery, 12(1), 5-10. https://doi.org/10.11648/j.js.20241201.12

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ACS Style

Wu, J.; Xiao, Y.; Lin, H.; Ji, Z.; Zhang, G. Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report. J. Surg. 2024, 12(1), 5-10. doi: 10.11648/j.js.20241201.12

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AMA Style

Wu J, Xiao Y, Lin H, Ji Z, Zhang G. Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report. J Surg. 2024;12(1):5-10. doi: 10.11648/j.js.20241201.12

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@article{10.11648/j.js.20241201.12,
  author = {Jianxiong Wu and Yongchun Xiao and Hongsheng Lin and Zhisheng Ji and Guowei Zhang},
  title = {Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report},
  journal = {Journal of Surgery},
  volume = {12},
  number = {1},
  pages = {5-10},
  doi = {10.11648/j.js.20241201.12},
  url = {https://doi.org/10.11648/j.js.20241201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20241201.12},
  abstract = {Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease that affects the sacroiliac joints and surrounding joints. It is a seronegative spondyloarthritis that invades connective tissue. Managing cervical spine fractures in patients with AS is particularly challenging due to the severity of the deformity and the instability of the fracture. Cervical spine fracture combined with spinal cord injury is the leading cause of death and is strongly correlated with in-hospital mortality in patients with ankylosing spondylitis. There have been limited reports on the revision of cervical spine fractures after internal fixation in patients with AS. The case report is about a patient who is a 34-year-old man who underwent emergency surgery at a local hospital for a cervical spine fracture resulting from a car accident. A postoperative review revealed that the anterior internal fixation was detached, leading to a revision surgery being performed according to the patient's actual condition. Unfortunately, the internal fixation became dislodged fol-lowing the initial surgery, exacerbating the patient's condi-tion and leading to the development of pneumonia. In order to prevent the need for revision surgery, it is crucial to carefully evaluate and determine the most suitable surgical approach for patients with cervical spine fractures and spinal cord injury before proceeding with the initial surgery.
},
 year = {2024}
}

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TY  - JOUR
T1  - Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report
AU  - Jianxiong Wu
AU  - Yongchun Xiao
AU  - Hongsheng Lin
AU  - Zhisheng Ji
AU  - Guowei Zhang
Y1  - 2024/02/29
PY  - 2024
N1  - https://doi.org/10.11648/j.js.20241201.12
DO  - 10.11648/j.js.20241201.12
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 5
EP  - 10
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20241201.12
AB  - Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease that affects the sacroiliac joints and surrounding joints. It is a seronegative spondyloarthritis that invades connective tissue. Managing cervical spine fractures in patients with AS is particularly challenging due to the severity of the deformity and the instability of the fracture. Cervical spine fracture combined with spinal cord injury is the leading cause of death and is strongly correlated with in-hospital mortality in patients with ankylosing spondylitis. There have been limited reports on the revision of cervical spine fractures after internal fixation in patients with AS. The case report is about a patient who is a 34-year-old man who underwent emergency surgery at a local hospital for a cervical spine fracture resulting from a car accident. A postoperative review revealed that the anterior internal fixation was detached, leading to a revision surgery being performed according to the patient's actual condition. Unfortunately, the internal fixation became dislodged fol-lowing the initial surgery, exacerbating the patient's condi-tion and leading to the development of pneumonia. In order to prevent the need for revision surgery, it is crucial to carefully evaluate and determine the most suitable surgical approach for patients with cervical spine fractures and spinal cord injury before proceeding with the initial surgery.

VL  - 12
IS  - 1
ER  -

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Author Information

Jianxiong Wu

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Yongchun Xiao

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Hongsheng Lin

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Zhisheng Ji

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China
Guowei Zhang

Department of Orthopedics, The First Affiliated Hospital of Jinan University, Guangzhou, China

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Plain Text BibTeX RIS

APA Style

Wu, J., Xiao, Y., Lin, H., Ji, Z., Zhang, G. (2024). Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report. Journal of Surgery, 12(1), 5-10. https://doi.org/10.11648/j.js.20241201.12

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ACS Style

Wu, J.; Xiao, Y.; Lin, H.; Ji, Z.; Zhang, G. Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report. J. Surg. 2024, 12(1), 5-10. doi: 10.11648/j.js.20241201.12

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AMA Style

Wu J, Xiao Y, Lin H, Ji Z, Zhang G. Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report. J Surg. 2024;12(1):5-10. doi: 10.11648/j.js.20241201.12

Copy | Download

@article{10.11648/j.js.20241201.12,
  author = {Jianxiong Wu and Yongchun Xiao and Hongsheng Lin and Zhisheng Ji and Guowei Zhang},
  title = {Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report},
  journal = {Journal of Surgery},
  volume = {12},
  number = {1},
  pages = {5-10},
  doi = {10.11648/j.js.20241201.12},
  url = {https://doi.org/10.11648/j.js.20241201.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20241201.12},
  abstract = {Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease that affects the sacroiliac joints and surrounding joints. It is a seronegative spondyloarthritis that invades connective tissue. Managing cervical spine fractures in patients with AS is particularly challenging due to the severity of the deformity and the instability of the fracture. Cervical spine fracture combined with spinal cord injury is the leading cause of death and is strongly correlated with in-hospital mortality in patients with ankylosing spondylitis. There have been limited reports on the revision of cervical spine fractures after internal fixation in patients with AS. The case report is about a patient who is a 34-year-old man who underwent emergency surgery at a local hospital for a cervical spine fracture resulting from a car accident. A postoperative review revealed that the anterior internal fixation was detached, leading to a revision surgery being performed according to the patient's actual condition. Unfortunately, the internal fixation became dislodged fol-lowing the initial surgery, exacerbating the patient's condi-tion and leading to the development of pneumonia. In order to prevent the need for revision surgery, it is crucial to carefully evaluate and determine the most suitable surgical approach for patients with cervical spine fractures and spinal cord injury before proceeding with the initial surgery.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - Cervical Vertebrae Internal Fixation Revision in a Patient with Ankylosing Spondylitis: A Case Report
AU  - Jianxiong Wu
AU  - Yongchun Xiao
AU  - Hongsheng Lin
AU  - Zhisheng Ji
AU  - Guowei Zhang
Y1  - 2024/02/29
PY  - 2024
N1  - https://doi.org/10.11648/j.js.20241201.12
DO  - 10.11648/j.js.20241201.12
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 5
EP  - 10
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20241201.12
AB  - Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease that affects the sacroiliac joints and surrounding joints. It is a seronegative spondyloarthritis that invades connective tissue. Managing cervical spine fractures in patients with AS is particularly challenging due to the severity of the deformity and the instability of the fracture. Cervical spine fracture combined with spinal cord injury is the leading cause of death and is strongly correlated with in-hospital mortality in patients with ankylosing spondylitis. There have been limited reports on the revision of cervical spine fractures after internal fixation in patients with AS. The case report is about a patient who is a 34-year-old man who underwent emergency surgery at a local hospital for a cervical spine fracture resulting from a car accident. A postoperative review revealed that the anterior internal fixation was detached, leading to a revision surgery being performed according to the patient's actual condition. Unfortunately, the internal fixation became dislodged fol-lowing the initial surgery, exacerbating the patient's condi-tion and leading to the development of pneumonia. In order to prevent the need for revision surgery, it is crucial to carefully evaluate and determine the most suitable surgical approach for patients with cervical spine fractures and spinal cord injury before proceeding with the initial surgery.

VL  - 12
IS  - 1
ER  -

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