Chen Weifu, Yang Yu, Pan Wenjun, Lei Xinhuan, Hong Zhenghua, Luo Hua
Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Taizhou, Zhejiang Province, China.
Front Neurol. 2024 Jul 2;15:1300597. doi: 10.3389/fneur.2024.1300597. eCollection 2024.
Ankylosing spondylitis (AS), an autoimmune disease, often leads to lower cervical spine fractures, with the potential for severe spinal nerve damage even from low-energy injuries. The optimal treatment approach remains debated.
A retrospective study involved 17 AS patients with lower cervical spine fractures who received anterior cervical fixation. Most presented cervicothoracic or thoracolumbar kyphosis, with 11 exhibiting neurological deficits. Patient characteristics, clinical data, visual analog scale (VAS), complications, and nerve recovery were analyzed.
No postoperative neurological deterioration occurred. All cases experienced complete fusion of fractures during the follow-up period. Preoperative VAS significantly decreased at 3 days and 3 months post-surgery. Of the 11 patients with preoperative neurological deficits, approximately 54.5% showed improvement post-surgery. No complications were reported, such as esophageal fistula, wound infection, or fixation failure.
Anterior internal fixation is a possible treatment for AS-related lower cervical fractures. This approach ensures satisfactory spinal stability and neurological recovery with proper cranial traction and external fixation post-surgery. Our findings demonstrate that this surgical method is safe and effective.
强直性脊柱炎（AS）是一种自身免疫性疾病，常导致下颈椎骨折，即使是低能量损伤也可能造成严重的脊神经损伤。最佳治疗方法仍存在争议。
一项回顾性研究纳入了17例接受前路颈椎固定术的AS下颈椎骨折患者。大多数患者表现为颈胸段或胸腰段后凸畸形，11例有神经功能缺损。分析了患者的特征、临床资料、视觉模拟评分（VAS）、并发症及神经恢复情况。
术后无神经功能恶化。所有病例在随访期间骨折均完全愈合。术前VAS在术后3天和3个月时显著降低。术前有神经功能缺损的11例患者中，约54.5%术后有所改善。未报告食管瘘、伤口感染或内固定失败等并发症。
前路内固定术是治疗AS相关性下颈椎骨折的一种可行方法。该方法通过术后适当的颅骨牵引和外固定，可确保满意的脊柱稳定性和神经功能恢复。我们的研究结果表明，这种手术方法安全有效。
