Neurologic complications following immobilization of cervical spine fracture in a patient with ankylosing spondylitis

✍ Scribed by Sherman M. Podolsky; Jerome R. Hoffman; Charles A. Pietrafesa

• Publisher: Elsevier Science
• Year: 1983
• Tongue: English
• Weight: 337 KB
• Volume: 12
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(83)80305-9

✦ Synopsis

Axial traction is widely recommended for stabilization of cervical spine fractures. This procedure may be inappropriate and even dangerous in patients with long-standing ankylosing spondylitis (AS). We present the case of an 80-year-old woman with AS who fell at home and suffered an unstable large C5-C6 fracture/dislocation associated with left-sided weakness and decreased sensation. Medical treatment included placing her neck in a neutral position, despite her preference for neck flexion. This procedure increased her pain and paresthesias; the complications decreased, but did not entirely resolve, when the patient resumed a semi-flexed position. This patient's neurologic sequelae may have been exacerbated by attempts to stabilize her neck in a neutral position. Standard stabilization recommendations should be appropriately altered in some patients with cervical spine AS.