Cargando…
Lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis
BACKGROUND: Ankylosing spondylitis (AS) is a seronegative spondyloarthropathy within the spectrum of rheumatologic diseases. The systemic inflammation that characterizes AS leads to bone resorption and reformation. Pathologic remodeling may include kyphosis, osteoporosis, and multi-segment auto-fusi...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238326/ https://www.ncbi.nlm.nih.gov/pubmed/30533272 http://dx.doi.org/10.4103/sni.sni_250_18 |
_version_ | 1783371353439600640 |
---|---|
author | Ahammad, Zubair Milton, Jason Narayan, Kailash Awuor, Victor |
author_facet | Ahammad, Zubair Milton, Jason Narayan, Kailash Awuor, Victor |
author_sort | Ahammad, Zubair |
collection | PubMed |
description | BACKGROUND: Ankylosing spondylitis (AS) is a seronegative spondyloarthropathy within the spectrum of rheumatologic diseases. The systemic inflammation that characterizes AS leads to bone resorption and reformation. Pathologic remodeling may include kyphosis, osteoporosis, and multi-segment auto-fusion. Cervical fractures account for 53–78% of spinal trauma seen with AS. Surgical planning is often challenging owing to spinal deformity, medical comorbidities, the cervicothoracic foci of injury, and gross instability of these fracture. CASE DESCRIPTION: A 55-year-old male with AS was presented with a three-column injury at the C6 level. The C6 vertebra was fractured, minimally displaced, and there was a focal kyphotic deformity. Attempted posterior fixation 2 days after presentation was aborted; the patient could not tolerate prone positioning, and there were further technical limitations to a posterior approach. Cervicothoracic fixation from C2 to T2 was then performed using the right lateral decubitus position employing the Mayfield head holder, a beanbag, and spinal neuronavigation. CONCLUSION: In this study, we presented a unique approach to posterior fixation of an unstable cervicothoracic fracture in a patient with AS utilizing the lateral position and neural navigation under intraoperative physiological monitoring. |
format | Online Article Text |
id | pubmed-6238326 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-62383262018-12-07 Lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis Ahammad, Zubair Milton, Jason Narayan, Kailash Awuor, Victor Surg Neurol Int Spine: Case Report BACKGROUND: Ankylosing spondylitis (AS) is a seronegative spondyloarthropathy within the spectrum of rheumatologic diseases. The systemic inflammation that characterizes AS leads to bone resorption and reformation. Pathologic remodeling may include kyphosis, osteoporosis, and multi-segment auto-fusion. Cervical fractures account for 53–78% of spinal trauma seen with AS. Surgical planning is often challenging owing to spinal deformity, medical comorbidities, the cervicothoracic foci of injury, and gross instability of these fracture. CASE DESCRIPTION: A 55-year-old male with AS was presented with a three-column injury at the C6 level. The C6 vertebra was fractured, minimally displaced, and there was a focal kyphotic deformity. Attempted posterior fixation 2 days after presentation was aborted; the patient could not tolerate prone positioning, and there were further technical limitations to a posterior approach. Cervicothoracic fixation from C2 to T2 was then performed using the right lateral decubitus position employing the Mayfield head holder, a beanbag, and spinal neuronavigation. CONCLUSION: In this study, we presented a unique approach to posterior fixation of an unstable cervicothoracic fracture in a patient with AS utilizing the lateral position and neural navigation under intraoperative physiological monitoring. Medknow Publications & Media Pvt Ltd 2018-11-02 /pmc/articles/PMC6238326/ /pubmed/30533272 http://dx.doi.org/10.4103/sni.sni_250_18 Text en Copyright: © 2018 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Spine: Case Report Ahammad, Zubair Milton, Jason Narayan, Kailash Awuor, Victor Lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis |
title | Lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis |
title_full | Lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis |
title_fullStr | Lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis |
title_full_unstemmed | Lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis |
title_short | Lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis |
title_sort | lateral position and utility of navigation for posterior fixation of unstable cervical fracture with ankylosing spondylitis |
topic | Spine: Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238326/ https://www.ncbi.nlm.nih.gov/pubmed/30533272 http://dx.doi.org/10.4103/sni.sni_250_18 |
work_keys_str_mv | AT ahammadzubair lateralpositionandutilityofnavigationforposteriorfixationofunstablecervicalfracturewithankylosingspondylitis AT miltonjason lateralpositionandutilityofnavigationforposteriorfixationofunstablecervicalfracturewithankylosingspondylitis AT narayankailash lateralpositionandutilityofnavigationforposteriorfixationofunstablecervicalfracturewithankylosingspondylitis AT awuorvictor lateralpositionandutilityofnavigationforposteriorfixationofunstablecervicalfracturewithankylosingspondylitis |