Ankylosing spondylitis of the craniovertebral junction: a single surgeon's experience

Gregory W Albert; Arnold H Menezes

doi:10.3171/2010.11.SPINE10279

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Ankylosing spondylitis of the craniovertebral junction: a single surgeon's experience

Journal article

Peer reviewed

Ankylosing spondylitis of the craniovertebral junction: a single surgeon's experience

Gregory W Albert and Arnold H Menezes

Journal of neurosurgery. Spine, Vol.14(4), pp.429-436

04/2011

DOI: 10.3171/2010.11.SPINE10279

PMID: 21294612

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Abstract

The objective of this study was to describe a single surgeon's experience managing craniovertebral junction (CVJ) disease due to ankylosing spondylitis. The authors undertook a retrospective review of the records of patients with CVJ disease due to ankylosing spondylitis who were evaluated and treated by the senior author. Charts were reviewed for symptoms and signs at presentation, radiography results, treatment, and outcome. In addition, some of the patients had pathology reports available for review. Eight patients with CVJ disease due to ankylosing spondylitis were identified who were evaluated by the senior author in the years 1990-2008. The most common presenting symptoms were neck pain (37.5%), cranial neuropathy (37.5%), and sensory disturbance (62.5%). On examination, the most common findings were limited cervical range of motion (37.5%), weakness (50%), and myelopathy (75%). Radiographic evaluation revealed atlantoaxial subluxation, retroodontoid pannus formation, basilar invagination, and bone erosion. Surgery was offered to all of the patients, 7 of whom underwent operations. In most cases, the treatment was transoral-transpalatopharyngeal decompression followed by occipitocervical fusion. One patient with a reducible lesion underwent dorsal fusion alone. Neurological outcomes were favorable overall. The incidence of CVJ disease in patients with ankylosing spondylitis varies among reports. These cases are rare in most neurosurgery clinics. It is important to recognize that patients with ankylosing spondylitis are at risk for CVJ disease, similar to patients with rheumatoid arthritis. Principles common to the management of other CVJ pathologies apply to these patients as well.

Atlanto-Axial Joint - diagnostic imaging

Cervical Vertebrae - diagnostic imaging

Humans

Middle Aged

Male

Treatment Outcome

Spinal Fusion

Atlanto-Axial Joint - surgery

Decompression, Surgical

Spondylitis, Ankylosing - diagnostic imaging

Radiography

Cervical Vertebrae - surgery

Atlanto-Axial Joint - pathology

Cervical Vertebrae - pathology

Adult

Spondylitis, Ankylosing - surgery

Aged

Spondylitis, Ankylosing - pathology

Details

Title: Subtitle: Ankylosing spondylitis of the craniovertebral junction: a single surgeon's experience
Creators: Gregory W Albert - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA
Arnold H Menezes
Resource Type: Journal article
Publication Details: Journal of neurosurgery. Spine, Vol.14(4), pp.429-436
DOI: 10.3171/2010.11.SPINE10279
PMID: 21294612
NLM abbreviation: J Neurosurg Spine
ISSN: 1547-5654
eISSN: 1547-5646
Publisher: American Association of Neurological Surgeons; United States
Language: English
Date published: 04/2011
Academic Unit: Stead Family Department of Pediatrics; Neurosurgery; Otolaryngology
Record Identifier: 9984040008602771

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