Management of cervical deformity in ankylosing spondylitis

✓ Ankylosing spondylitis can lead to severe cervical kyphosis, causing problems with forward vision, swallowing, hygiene, patient functionality, and social outlook. Evaluation of patients with cervical flexion deformity includes assessment of global sagittal balance and chin–brow angle. The primary treatment in extreme disabling cases is surgical correction involving a posterior cervical extension osteotomy, which is a technically demanding procedure with considerable risk of neurological injury. To address the potential complications with extension osteotomy, the authors of several reports have described modifications to the surgical technique. These developments incorporate recent advances in anesthesia, neuromonitoring, and spinal instrumentation. Complications associated with the procedure include subluxation at the osteotomy level, spinal cord injury, radiculopathy, dysphagia, and pseudarthrosis. Although the risks of spinal correction are considerable, extension osteotomy remains an effective treatment modality for patients with disabling cervical flexion deformity.

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Delayed Postoperative Paravertebral Abscess in a Patient with Cervical Spinal Cord Injury Accompanied by Ankylosing Spondylitis

Clinical Pain ◽

10.35827/cp.2021.20.2.145 ◽

2021 ◽

Vol 20 (2) ◽

pp. 145-150

Author(s):

Geon Jae Lee ◽

Jang Woo Lee

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Ankylosing Spondylitis ◽

Cervical Spinal Cord ◽

Cervical Spinal Cord Injury ◽

Paravertebral Abscess ◽

Cord Injury

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Heterotopic ossification in a patient with cervical spinal cord injury and ankylosing spondylitis: The consequences of the late diagnosis

The Journal of the International Society of Physical and Rehabilitation Medicine ◽

10.4103/jisprm.jisprm_20_20 ◽

2020 ◽

Vol 3 (3) ◽

pp. 97

Author(s):

Celine Lakra ◽

Manish Desai

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Ankylosing Spondylitis ◽

Heterotopic Ossification ◽

Cervical Spinal Cord ◽

Cervical Spinal Cord Injury ◽

Late Diagnosis ◽

Cord Injury

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Evolution of traumatic spinal cord injury in patients with ankylosing spondylitis, in a Romanian rehabilitation clinic

Spinal Cord Series and Cases ◽

10.1038/scsandc.2016.1 ◽

2016 ◽

Vol 2 (1) ◽

Cited By ~ 4

Author(s):

Aurelian Anghelescu ◽

Liliana Valentina Onose ◽

Cristina Popescu ◽

Ioana Andone ◽

Cristina Octaviana Daia ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Ankylosing Spondylitis ◽

Traumatic Spinal Cord Injury ◽

Cord Injury ◽

Rehabilitation Clinic

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Robotic-Assisted, Body-Weight–Supported Treadmill Training in Individuals Following Motor Incomplete Spinal Cord Injury

Physical Therapy ◽

10.1093/ptj/85.1.52 ◽

2005 ◽

Vol 85 (1) ◽

pp. 52-66 ◽

Cited By ~ 165

Author(s):

T George Hornby ◽

David H Zemon ◽

Donielle Campbell

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Body Weight ◽

Physical Therapists ◽

Treadmill Training ◽

Neurological Injury ◽

Walking Ability ◽

Incomplete Spinal Cord Injury ◽

Robotic Assisted ◽

Cord Injury

AbstractBackground and Purpose. Performance of therapist-assisted, body-weight–supported treadmill training (BWSTT) to enhance walking ability of people with neurological injury is an area of intense research. Its application in the clinical setting, however, is limited by the personnel and labor requirements placed on physical therapists. Recent development of motorized (“robotic”) rehabilitative devices that provide assistance during stepping may improve delivery of BWSTT. Case Description. This case report describes the use of a robotic device to enhance motor recovery and ambulation in 3 people following motor incomplete spinal cord injury. Interventions. Changes in motor impairment, functional limitations, and locomotor disability were monitored weekly during robotic-assisted BWSTT and following transition to therapist-assisted BWSTT with the assistance of one therapist. Outcomes. Following this training, 2 patients recovered independent over-ground walking and another improved his gait speed and endurance. Discussion. The use of robotic devices may assist physical therapists by providing task-specific practice of stepping in people following neurological injury.

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Use of hinged rods for controlled osteoclastic correction of a fixed cervical kyphotic deformity in ankylosing spondylitis

Journal of Neurosurgery Spine ◽

10.3171/spi/2008/8/6/579 ◽

2008 ◽

Vol 8 (6) ◽

pp. 579-583 ◽

Cited By ~ 20

Author(s):

Paul Khoueir ◽

Daniel J. Hoh ◽

Michael Y. Wang

Keyword(s):

Ankylosing Spondylitis ◽

Spinal Column ◽

Spinal Fracture ◽

Neurological Injury ◽

Osteotomy Site ◽

The Novel ◽

Flexion Deformity ◽

Cervical Kyphosis ◽

Horizontal Gaze ◽

Neurologically Intact

✓Cervical kyphosis in patients with ankylosing spondylitis (AS) can be severely disabling. Surgical treatment of this disorder is technically demanding, however, with a considerable risk of neurological and vascular injuries. The extension osteotomy is a well-described posterior treatment for this condition, but this approach presents the risk of acute subluxation and spinal column translation during the reduction. In this paper, the authors report the novel use of a hinged posterior cervical rod for controlled correction of cervical kyphosis. After sustaining a traumatic spinal fracture, a 57-year-old man with AS developed a delayed cervical flexion deformity. The patient was neurologically intact, but suffered from disabling impairment in horizontal gaze and activities of daily living, and from neck pain. The patient subsequently underwent surgical correction via a posterior cervical extension osteotomy at C7–T1 with manual extension of the neck for osteoclastic reduction of the cervical kyphosis. Controlled correction was performed by using a hinged rod affixed to posterior cervical and thoracic screws, allowing for free sagittal correction while restricting translational forces. Once the desired angle of correction was achieved, the hinge connector was locked, transforming the rod into a rigid device for permanent internal fixation. The use of hinged rods in cervical kyphosis correction provides a controlled method for reduction at the osteotomy site, decreasing the risk of neurological injury.

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Pediatric spinal injury: the very young

Journal of Neurosurgery ◽

10.3171/jns.1988.68.1.0025 ◽

1988 ◽

Vol 68 (1) ◽

pp. 25-30 ◽

Cited By ~ 196

Author(s):

John R. Ruge ◽

Grant P. Sinson ◽

David G. McLone ◽

Leonard J. Cerullo

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Cord Injuries ◽

Spinal Injury ◽

Causative Factor ◽

Important Variable ◽

Neurological Injury ◽

Content Type ◽

Significant Difference ◽

Cord Injury

✓ Maturity of the spine and spine-supporting structures is an important variable distinguishing spinal cord injuries in children from those in adults. Cinical data are presented from 71 children aged 12 years or younger who constituted 2.7% of 2598 spinal cord-injured patients admitted to the authors' institutions from June, 1972, to June, 1986. The 47 children with traumatic spinal cord injury averaged 6.9 years of age and included 20 girls (43%). The etiology of the pediatric injuries differed from that of adult injuries in that falls were the most common causative factor (38%) followed by automobile-related injuries (20%). Ten children (21.3%) had spinal cord injury without radiographic abnormality (SCIWORA), whereas 27 (57%) had evidence of neurological injury. Complete neurological injury was seen in 19% of all traumatic pediatric spinal cord injuries and in 40% of those with SCIWORA. The most frequent level of spinal injury was C-2 (27%, 15 cases) followed by T-10 (13%, seven cases). Upon statistical examination of the data, a subpopulation of children aged 3 years or younger emerged. These very young children had a significant difference in level of injury, requirement for surgical stability, and sex distribution compared to 4- to 12-year-old children.

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A Case Report of Ankylosing Spondylitis with Spinal Cord Injury.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.48.1 ◽

1999 ◽

Vol 48 (1) ◽

pp. 1-6

Author(s):

Tatsunobu Abe ◽

Toyonobu Yoshimura ◽

Shigetoshi Ito ◽

Mari Araki ◽

Hiroshi Kawaguchi ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Case Report ◽

Ankylosing Spondylitis ◽

Cord Injury

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The Potential of Curcumin in Treatment of Spinal Cord Injury

Neurology Research International ◽

10.1155/2016/9468193 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 12

Author(s):

Raghavendra Sanivarapu ◽

Vijayalakshmi Vallabhaneni ◽

Vivek Verma

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Treatment Options ◽

Current Treatment ◽

Neurological Injury ◽

Standards Of Care ◽

Current Therapy ◽

Clinical Perspective ◽

Cord Injury ◽

Immense Potential

Current treatment for spinal cord injury (SCI) is supportive at best; despite great efforts, the lack of better treatment solutions looms large on neurological science and medicine. Curcumin, the active ingredient in turmeric, a spice known for its medicinal and anti-inflammatory properties, has been validated to harbor immense effects for a multitude of inflammatory-based diseases. However, to date there has not been a review on curcumin’s effects on SCI. Herein, we systematically review all known data on this topic and juxtapose results of curcumin with standard therapies such as corticosteroids. Because all studies that compare the two show superior results for curcumin over corticosteroids, it could be true that curcumin better acts at the inflammatory source of SCI-mediated neurological injury, although this question remains unanswered in patients. Because curcumin has shown improvements from current standards of care in other diseases with few true treatment options (e.g., osteoarthritis), there is immense potential for this compound in treating SCI. We critically and systematically summarize available data, discuss clinical implications, and propose further testing of this well-tolerated compound in both the preclinical and the clinical realms. Analyzing preclinical data from a clinical perspective, we hope to create awareness of the incredible potential that curcumin shows for SCI in a patient population that direly needs improvements on current therapy.

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