{"id":"2b5ad8cd-579a-456e-a72d-80a8394b696e","slug":"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","authors":["Zubair Ahammad","Jason Milton","Kailash Narayan","Victor Awuor"],"abstract":"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.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/2b5ad8cd-579a-456e-a72d-80a8394b696e/featured/hero-1782420847755.png","publishDate":"2018-11-02T00:00:00.000Z","doi":"10.4103/sni.sni_250_18","categories":["Spine","Case Report"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2018/11/9061/SNI-9-225.pdf"}