CERVICAL-SPINE SURGERY IN ANKYLOSING-SPONDYLITIS - IS THE OUTCOME GOOD

Objective. To assess retrospectively, the outcome of cervical spine su rgery in patients with ankylosing spondylitis (AS). Methods. A cross-s ectional study of 3464 patients with identified AS, 19 patients of who m had cervical spine surgery. A self-administered questionnaire (inclu ding the use of 10 cm visual analogue scales, 0 = none, 10 = worst) as sessing the complications of the surgery, patients' neck symptoms and post-surgery functional ability was sent to the 19 patients. Available casenotes and radiographs were reviewed. Results. The mean duration o f follow-up was 10 years. One patient had two separate cervical spine operations. The types of surgery performed included cervical fusion (n =7), osteotomy (n=7) and laminectomy (n=6). Six patients had minor com plications as a result of surgery. The majority of patients (93%) felt that their surgery had been successful. Most patients (81%) had a red uction in neck pain (mean pain score=3.1, SD 2.8) but increased neck s tiffness (mean stiffness score=8.0, SD 2.9). Postoperative radiographs of 7 patients showed complete ankylosis of the cervical spine. Genera lly, few patients reported difficulty with reading/watching television (6%), sleep (19%) or driving (36%). A third of the patients were stil l in full time employment. Conclusions. About 1 in 200 patients with A S undergo cervical spine surgery. The surgery is often successful and complications are usually minor. Neck pain is often better after surge ry and any remaining neck symptoms do not significantly affect the pat ient's sleep or functional activities. In this retrospective study, th e long term outcome of cervical spine surgery in patients with AS appe ars to be good.