Spinal Trauma Unit, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, England.
Spinal Trauma Unit, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, England.
World Neurosurg. 2019 Nov;131:27-31. doi: 10.1016/j.wneu.2019.07.158. Epub 2019 Jul 26.
Ankylosing spondylitis (AS) is a systemic enthesopathy. In its presence, spinal fractures are often unstable. Acknowledging the preinjury level of kyphosis is key in the management of cervical fractures, and placement into a hard collar has been shown to result in life-threatening spinal cord complications.
This report presents the unique case of a patient with AS who developed a unilateral C5 palsy after the application of a hard collar for a C5/6 fracture, to our knowledge the first such case presented to date. The patient subsequently went on to an anterior fixation and partially recovered from the C5 palsy/injury. After the case report is an examination of the currently available literature and evidence exploring the factors that may contribute to C5 palsy after the application of a collar for acute fracture in AS.
We described the first case in the literature of a posttraumatic C5 palsy after application of a hard collar in AS. This report and literature review should act to underscore the importance of respecting a preexisting rigid kyphotic deformity in cervical fractures but also to stimulate further thoughts and investigations into what may contribute to a posttraumatic C5 palsy.
强直性脊柱炎（AS）是一种全身性附着病。AS 存在时，脊柱骨折通常不稳定。在治疗颈椎骨折时，了解损伤前的后凸程度是关键，而且已经证明使用硬领会导致危及生命的脊髓并发症。
本报告介绍了一例独特的 AS 患者病例，在使用硬领治疗 C5/6 骨折后出现单侧 C5 神经麻痹，据我们所知，这是迄今为止首例此类病例。患者随后进行了前路固定，并部分恢复了 C5 神经麻痹/损伤。病例报告后，对目前可用的文献和证据进行了检查，探讨了在 AS 急性骨折应用领固定后导致 C5 神经麻痹的可能因素。
我们描述了首例 AS 患者在应用硬领后发生创伤性 C5 神经麻痹的病例。本报告和文献复习应强调在颈椎骨折中尊重先前存在的僵硬性后凸畸形的重要性，但也应激发进一步思考和研究导致创伤后 C5 神经麻痹的因素。
