Surgical treatment of a cervical spine fracture in an ankylosing spondylitis patient with severe global spine kyphosis and chin-on-chest deformity

To the Editor:Kyphotic deformity is one of the main manifestations of ankylosing spondylitis(AS).Usually,the hyperkyphosis is distributed along the lumbar,thoracolumbar,and thoracic spine,since the ossification of the spinal column mainly starts at the sacroiliac joint and then progresses towards the head.111 Occasionally,the kyphotic deformity occurs in the cervicothoracic spine,resulting in the chin resting on the chest,called chin-on-chest deformity?Patients with chin-on-chest deformity may have problems with horizontal gaze,chewing and swallowing,maintaining and performing proper personal hygiene,and they may suffer from neck pain and myelopathy.[1]However,severe global spine kyphosis in AS,resulting in a curvature of the upper body resembling the letter C,is an extremely rare condition with a simultaneous lumbar,thoracic,and cervicothoracic kyphosis.When cervical spine fractures happen in these patients,it is very challenging to deal with them,because of the severity of the deformity and the instability of the fracture.In this study,we report our experience in the treatment of a patient reporting these problems.