Operative stabilization of the remaining mobile segment in ankylosed cervical spine in systemic onset - juvenile idiopathic arthritis: A case report

Table 1 Characteristics of first-reported case of long-segment cervical fusion[5]

Patient characteristics

27-yr-old female

JIA for 10 yr

Symptoms

Posterior neck pain

Progressive weakness

Paresthesia and dysesthesia below the C7 dermatome

Imaging

Spontaneus apophyseal joint fusion from the occipital condyle to C6

Instability at C6/C7 level - only mobile segment

Problems during procedure

Contracture of temporo-mandibular joint

Endotracheal intubation not feasible due to stiff neck

Tracheostomy needed

Severe osteoporosis noted

Approach/type of fixation

Posterior approach

Decompressive subtotal laminectomy

Interspinous process wiring with titanium-braded cable and addition of integrated bone graft at C6/7 level

Results

Pathologic reflexes disappeared

Well established bone graft incorporation 6 mo post-op

Conclusion

First-reported case of long-segment cervical fusion, may be related with rapid progression of the disease

JIA: Juvenile idiopathic arthritis.