Article: PDF OnlyFox Mark W.; Onofrio, Burton M.Neurosurgery Quarterly: September 1993 - p 165-177 Buy Abstract Summary Ankylosing spondylitis (AS), a common rheumatologic disorder affecting the spinal column, has an estimated incidence of 1 to 2% in the general population. These patients are specifically prone to neurologic complications secondary to spinal column fractures, progressive spinal deformity, atlantoaxial subluxation, and spinal stenosis. We outline the pathophysiology of this disorder, describe the common spinal complications, and then detail the medical and surgical management of these conditions. We review our 5-year retrospective experience with 33 patients who underwent 41 surgical procedures for spinal disorders secondary to ankylosing spondylitis. Seventeen cervical procedures, 14 thoracic, and 10 lumbar surgeries were performed. Eight patients had two or more disorders during the evaluation period requiring surgery. Thirteen patients had preoperative neurologic deficits that improved in 9 patients and stabilized in 4 after surgery. We conclude that neurologic compromise is common in these patients due to the brittle nature of the spine and the tendency for fractures or deformity to occur. Our experience suggests that thorough radiologic evaluation, extreme caution with endotracheal intubation and with Halo or traction applications, early surgical spinal immobilization, and aggressive postoperative mobilization of patients are necessary for successful outcome. Satisfactory neurologic outcome can be achieved when patients are carefully managed. © Williams & Wilkins 1993. All Rights Reserved.