The Study On Treatment And Clinical Characteristics Of Cervical Spine Fracture In Patients With Ankylosing Spondylitis

Objective: To explore the clinical characteristics,treatment methods and curative effect of ankylosing spondylitis with cervical spine fracture.Methods: Clinical data of 37 cases(2008.04-2016.01)of cervical spine fracture with ankylosing spondylitis were analyzed retrospectively.Analysis the follow-up information and relevant imaging data to summarize its clinical characteristics,get the assessment of patients with neurological function recovery and its prognosis.Pre-and post-operative neurologic functions were evaluated by ASIA grade.Pre-and post-operative JOA scores and VAS were measured to evaluate the curative effect.Fracture fusion and spinal cord decompression conditions were evaluated according to X-ray,Three-dimensional CT,MRI at the postoperative follow-up.Results: 37 cases were treated with surgery in 34 cases,conservative treatment in 3 cases.There was 1 case with anterior secondary surgery and posterior fixation after one week reached bony fusion at final follow-up.The rest of the patients achieved good restoration and fusion.No shift/dislocation happened again and the cervical spine alignment sequence was fine.There was significant difference on VAS scores between preoperation 9.03±0.72 and postoperation 2.03±0.94(P<0.05).There was significant difference on JOA scores between preoperation 6.53±3.20 and postoperation 12.97±3.68(P<0.05).There was significant difference on ASIA grade between preoperation and postoperation(P<0.05).The preoperative and postoperative ASIA scores were compared by paired rank sum test.Compared with the preoperative VAS scores,JOA scores,the two groups of patients with simple one stage anterior approach and one stage posterior approach were all statistically significant,but there was no difference between the two groups.The amount of blooding(73.85±29.87)ml and operation time(121.54±57.86)min of the one stage anterior approach group were significantly better when compared with the one stage posterior approach group(314.44±331.73)ml,(181.39±61.30)min(P<0.05).Conclusion: The majority of AS combined with cervical fractures were three column and highly unstable fracture.Surgical decompression and stabilization of the spine should be performed as soon as possible to minimize the probability and extent of spinal cord injury.Provide personalized treatment,its operation,fixed segment according to the patient’s disease development stage and the image characteristics of the comprehensive selection.