Corrective surgery for deformity of the upper cervical spine due to ankylosing spondylitis

Abstract

Rotational and flexion deformity of C1-C2 due to ankylosing spondylitis is rare. We did surgical correction in one such case by lateral release, resection of the posterior arch of C1 and mobilization of the vertebral arteries, wedge osteotomy of the lateral masses of C1 and internal fixation under general anesthesia. There were no vascular and neurological complications during the surgery. After operation the atlantoaxial rotational deformity was corrected and the normal cervical lordosis was restored. At 1 year followup his visual field and feeding became normal and internal fixation was stable.

Chin on Chest Deformity Caused by Upper Cervical Kyphosis Associated With Ankylosing Spondylitis: A Case Report

“…Therefore, majority of the surgical reports had been about correction of the kyphotic thoracic and lumbar spine, and reports on correction of the upper cervical spine are extremely rare. We found only 2 cases that underwent correction surgery for upper cervical kyphosis associated with AS [ 2 , 3 ]. Lin et al [ 2 ] corrected a C1/2 deformity using a technique that comprised resection of the posterior arch of C1, mobilization of the vertebral arteries, wedge osteotomy of the lateral masses in C1, and internal fixation.…”

“…We found only 2 cases that underwent correction surgery for upper cervical kyphosis associated with AS [ 2 , 3 ]. Lin et al [ 2 ] corrected a C1/2 deformity using a technique that comprised resection of the posterior arch of C1, mobilization of the vertebral arteries, wedge osteotomy of the lateral masses in C1, and internal fixation. Grundy corrected a C1/2 deformity by a technique that comprised wedge osteotomy of the lateral masses in C1 and of the odontoid process through a posterior approach [ 3 ].…”

“…However, surgical treatment of the Neurospine eISSN 2586-6591 pISSN 2586-6583 upper cervical spine has been extremely rare. 2,3 In this case report, we describe a woman who was surgically treated for chin on chest deformity caused by upper cervical kyphosis associated with AS. The patient developed iatrogenic fracture of the cervical spine during correction and eventually obtained sufficient correction because of the fracture, fortunately without any devastating complications.…”

“…Surgical treatment of the thoracic and lumbar spine in patients with fixed flexion deformity had been previously reported. However, surgical treatment of the upper cervical spine has been extremely rare [ 2 , 3 ].…”