Acute Cervical Fractures in Ankylosing Spondylitis
Bibliographic record
Abstract
In Brief Study Design. A new technique for the management of traumatic cervical fracture in patients with chin-on-chest deformity in ankylosing spondylitis is presented. Objective. To present a new surgical technique for acute deformity correction through cervical fractures in the setting of kyphotic deformities. Summary of Background Data. Cervicothoracic kyphotic deformity in ankylosing spondylitis is currently treated with extension osteotomy in an elective setting. In elective extension osteotomies, the surgeon manipulates the head to generate osteoclasis, temporarily producing an unstable cervical fracture. Cervical fractures in ankylosing spondylitis are highly unstable and frequently associated with neurologic compromise. Most reports describe either no reduction and fixation in situ or reduction in preoperative traction followed by fixation. Methods. A 60-year-old man with chronic ankylosing spondylitis and profound kyphotic deformity suffered a traumatic lower cervical spine fracture. He was treated with an acute cervical spine extension osteotomy through the fracture site using an anterior lengthening bar modification to a halo vest. The anterior lengthening bar allows controlled extension of the neck without manual manipulation by the surgeon. Results. This patient presented with a chin-brow angle of approximately 90° and was corrected to approximately 5° to 8°. No immediate or delayed complications were seen. After halo vest treatment for 3 months, an excellent postural correction was obtained. Conclusion. Surgical extension osteotomy in the lower cervical spine through the fracture site using the anterior lengthening bar-halo extension brace seems to be a safe method for correcting spine flexion deformity in ankylosing spondylitis after traumatic fracture. Acute cervical fractures in patients with preexisting chin-on-chest deformity in ankylosing spondylitis can be treated with a gradual and controlled extension osteotomy through the fracture site, using an anterior lengthening bar modification to a halo vest. This method seems to be a safe, effective treatment for cervical spine fracture in ankylosing spondylitis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".