Artikel
Cervical vertebral body fracture with Ankylosing spondylitis treated with cervical pedicle screw: A case report and fracture body overlapping reduction technique
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Veröffentlicht: | 8. Juni 2016 |
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Objective: To describe an Ankylosing spondylitis (AS) patient with cervical spinal fracture treated with cervical pedicle screw (CPS) through single posterior approach.
Method: A 43-years-old male patient with AS visited our emergency center due to paralysis after traffic accident. Coronal reconstructed cervical spine computed tomography (CT) scan showed C5 oblique fracture and bilateral pedicles were separated superiorly and inferiorly. Sagittal reconstructed CT image revealed bamboo spine and C5 vertebrae body fracture. Hyperextension between fractured segments of C5 body was noted because fracture gap was anteriorly opened. MRI showed cord compression and injury at C4-5 level.
Results: CPS was performed at C3-4-5-6 levels. Because left and right pedicles were displaced superiorly and inferiorly, dual compressions between left C5 pedicle screw and left C6 pedicle screw and between right C5 pedicle screw and right C4 pedicle screw were done. Decompression at C4 and C5 levels was done after identifying good alignment. Then, posterolateral fusion was done. Operation interval was two hours. After surgery, X-ray showed complete reduction and fracture gap apposition were seen. Rehabilitation was done and all his muscle strengths improved. Postoperative 4 month CT and X-rays revealed complete fracture site fusion and correct position of CPS.
Conclusions: We showed that C5 vertebral body oblique fracture with AS patient was successfully treated with short level CPS and complete reduction fracture body overlapping technique only with posterior approach. Considering increased morbidity of long-level or -duration surgery, our technique seems to be one possible and good surgical method in traumatic cervical fracture with AS.