Neurologic complications following immobilization of cervical spine fracture in a patient with ankylosing spondylitis

Ann Emerg Med. 1983 Sep;12(9):578-80. doi: 10.1016/s0196-0644(83)80305-9.


Axial traction is widely recommended for stabilization of cervical spine fractures. This procedure may be inappropriate and even dangerous in patients with long-standing ankylosing spondylitis (AS). We present the case of an 80-year-old woman with AS who fell at home and suffered an unstable large C5-C6 fracture/dislocation associated with left-sided weakness and decreased sensation. Medical treatment included placing her neck in a neutral position, despite her preference for neck flexion. This procedure increased her pain and paresthesias; the complications decreased, but did not entirely resolve, when the patient resumed a semi-flexed position. This patient's neurologic sequelae may have been exacerbated by attempts to stabilize her neck in a neutral position. Standard stabilization recommendations should be appropriately altered in some patients with cervical spine AS.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Female
  • Fractures, Bone / complications*
  • Fractures, Bone / etiology
  • Humans
  • Paresthesia / etiology*
  • Posture
  • Spinal Cord Compression / etiology
  • Spinal Injuries / complications*
  • Spinal Injuries / etiology
  • Spondylitis, Ankylosing / complications*
  • Traction / adverse effects*