Management of cervical deformity in ankylosing spondylitis

Daniel J. Hoh, Paul Khoueir, Michael Y. Wang

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


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.

Original languageEnglish (US)
Article numberE9
JournalNeurosurgical focus
Issue number1
StatePublished - Jan 1 2008


  • Ankylosing spondylitis
  • Cervical kyphosis
  • Chin-on-chest deformity
  • Spinal deformity
  • Surgical correction
  • Surgical technique

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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