CERVICAL OSTEOTOMY FOR THE FLEXED CERVICAL-SPINE IN ANKYLOSING-SPONDYLITIS

Patients with ankylosing spondylitis characteristically develop a thor acic kyphosis associated with flattening of the lumbar lordosis, but a proportion develop severe fixed flexion deformity of the neck. Few pr evious reports exist of planned surgical correction, reflecting the fe ar of catastrophic complications. Seven patients have undergone cervic al osteotomy. Fibreoptic bronchoscopy allowed safe and predictable gen eral anaesthesia, by permitting endotracheal intubation in conscious p atients. Osteotomy corrected deformity to restore horizontal gaze in a ll patients. Mean correction of deformity was 31 degrees. There were n o major neurological complications and all had satisfactory results 1- 4 years after operation.