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Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis

The present study aimed to explore surgical treatments and assess the effects based on the features of cervical spine fracture in patients with ankylosing spondylitis (AS) and to summarize the experiences in perioperative management. Retrospective analysis was performed in 25 AS patients with cervic...

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Autores principales: Ma, Jun, Wang, Ce, Zhou, Xuhui, Zhou, Shengyuan, Jia, Lianshun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915866/
https://www.ncbi.nlm.nih.gov/pubmed/26554765
http://dx.doi.org/10.1097/MD.0000000000001663
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author Ma, Jun
Wang, Ce
Zhou, Xuhui
Zhou, Shengyuan
Jia, Lianshun
author_facet Ma, Jun
Wang, Ce
Zhou, Xuhui
Zhou, Shengyuan
Jia, Lianshun
author_sort Ma, Jun
collection PubMed
description The present study aimed to explore surgical treatments and assess the effects based on the features of cervical spine fracture in patients with ankylosing spondylitis (AS) and to summarize the experiences in perioperative management. Retrospective analysis was performed in 25 AS patients with cervical spine fracture treated in our hospital from January 2011 to December 2013. The patients were divided according to fracture segments, including 4 cases at C4 to C5, 8 cases at C5 to C6, and 13 cases at C6 to C7. Among them, 12 belonged to I type, 5 to II type, and 8 to III type based on the improved classification method for AS cervical spine fracture. The Subaxial Cervical Spine Injury Classification score for these patients was 7.2 ± 1.3, and the assessment of their neurological function states showed 6 patients (24%) were in American Spinal Injury Association (ASIA) A grade, 1 (4%) in ASIA B grade, 3 (12%) in ASIA C grade, 12 (48%) in ASIA D grade, and 3 (12%) in ASIA E grade. Surgical methods contained simple anterior approach alone, posterior approach alone, and combined posterior–anterior or anterior–posterior approach. The average duration of patients’ hospital stay was 38.6 ± 37.6, and the first surgical methods were as follows: anterior approach alone on 6 cases, posterior surgery alone on 9 cases, and combined posterior–anterior or anterior–posterior approach on 10 patients. The median segments of fixation and fusion were 4.1 ± 1.4 sections. Thirteen patients developed complications. During 2 to 36 months of postoperative follow-up, 1 patient died of respiratory failure caused by pulmonary infections 2 months after leaving hospital. At the end of the follow-up, bone graft fusion was achieved in the rest of patients, and obvious looseness or migration of internal fixation was not observed. In addition, the preoperative neurological injury in 12 patients (54.5%) was also alleviated in different levels. AS cervical spine fracture, an unstable fracture, should be treated with operation, and satisfactory effects will be achieved after the individualized surgical treatment according to the improved classification method for AS cervical spine fracture.
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spelling pubmed-49158662016-07-05 Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis Ma, Jun Wang, Ce Zhou, Xuhui Zhou, Shengyuan Jia, Lianshun Medicine (Baltimore) 7100 The present study aimed to explore surgical treatments and assess the effects based on the features of cervical spine fracture in patients with ankylosing spondylitis (AS) and to summarize the experiences in perioperative management. Retrospective analysis was performed in 25 AS patients with cervical spine fracture treated in our hospital from January 2011 to December 2013. The patients were divided according to fracture segments, including 4 cases at C4 to C5, 8 cases at C5 to C6, and 13 cases at C6 to C7. Among them, 12 belonged to I type, 5 to II type, and 8 to III type based on the improved classification method for AS cervical spine fracture. The Subaxial Cervical Spine Injury Classification score for these patients was 7.2 ± 1.3, and the assessment of their neurological function states showed 6 patients (24%) were in American Spinal Injury Association (ASIA) A grade, 1 (4%) in ASIA B grade, 3 (12%) in ASIA C grade, 12 (48%) in ASIA D grade, and 3 (12%) in ASIA E grade. Surgical methods contained simple anterior approach alone, posterior approach alone, and combined posterior–anterior or anterior–posterior approach. The average duration of patients’ hospital stay was 38.6 ± 37.6, and the first surgical methods were as follows: anterior approach alone on 6 cases, posterior surgery alone on 9 cases, and combined posterior–anterior or anterior–posterior approach on 10 patients. The median segments of fixation and fusion were 4.1 ± 1.4 sections. Thirteen patients developed complications. During 2 to 36 months of postoperative follow-up, 1 patient died of respiratory failure caused by pulmonary infections 2 months after leaving hospital. At the end of the follow-up, bone graft fusion was achieved in the rest of patients, and obvious looseness or migration of internal fixation was not observed. In addition, the preoperative neurological injury in 12 patients (54.5%) was also alleviated in different levels. AS cervical spine fracture, an unstable fracture, should be treated with operation, and satisfactory effects will be achieved after the individualized surgical treatment according to the improved classification method for AS cervical spine fracture. Wolters Kluwer Health 2015-11-06 /pmc/articles/PMC4915866/ /pubmed/26554765 http://dx.doi.org/10.1097/MD.0000000000001663 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 7100
Ma, Jun
Wang, Ce
Zhou, Xuhui
Zhou, Shengyuan
Jia, Lianshun
Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis
title Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis
title_full Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis
title_fullStr Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis
title_full_unstemmed Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis
title_short Surgical Therapy of Cervical Spine Fracture in Patients With Ankylosing Spondylitis
title_sort surgical therapy of cervical spine fracture in patients with ankylosing spondylitis
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915866/
https://www.ncbi.nlm.nih.gov/pubmed/26554765
http://dx.doi.org/10.1097/MD.0000000000001663
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