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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...

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Autores principales: Ahammad, Zubair, Milton, Jason, Narayan, Kailash, Awuor, Victor
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
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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.
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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
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