Format

Send to

Choose Destination
Br Med Bull. 2015 Sep;115(1):57-66. doi: 10.1093/bmb/ldv010. Epub 2015 Mar 22.

Management of cervical fractures in ankylosing spondylitis: anterior, posterior or combined approach?

Author information

1
Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy.
2
Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Surgery, Salerno, Italy n.maffulli@qmul.ac.uk.

Abstract

INTRODUCTION:

Ankylosing spondylitis (AS) can lead to an increased risk of cervical fractures.

SOURCES OF DATA:

A systematic review was undertaken using the keywords 'ankylosing spondylitis', 'spine fractures', 'cervical fractures', 'surgery' and 'postoperative outcomes' on Medline, Pubmed, Google Scholar, Ovid and Embase, and the quality of the studies included was evaluated according to the Coleman Methodology Score.

AREAS OF AGREEMENT:

Surgery ameliorates neurological function in patients with unstable AS-related cervical fractures. The combined anterior/posterior and the posterior approaches are more effective than the anterior approach.

AREAS OF CONTROVERSY:

The optimal approach, anterior, posterior or combined anterior/posterior, for the management of AS related cervical fractures has not been defined.

GROWING POINTS:

Open reduction and internal fixation allows avoiding worsening and enhances neurological function in AS patients with cervical fractures.

AREAS TIMELY FOR DEVELOPING RESEARCH:

Adequately powered randomized trials with appropriate subjective and objective outcome measures are necessary to reach definitive conclusions.

KEYWORDS:

ankylosing spondylitis; cervical fractures; management; postoperative outcomes; spine fractures; surgery

PMID:
25800241
DOI:
10.1093/bmb/ldv010
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center