{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:13:35Z","timestamp":1788592415828,"version":"build-2803163510"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The objective of this study was to describe a single surgeon's experience managing craniovertebral junction (CVJ) disease due to ankylosing spondylitis.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors undertook a retrospective review of the records of patients with CVJ disease due to ankylosing spondylitis who were evaluated and treated by the senior author. Charts were reviewed for symptoms and signs at presentation, radiography results, treatment, and outcome. In addition, some of the patients had pathology reports available for review.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Eight patients with CVJ disease due to ankylosing spondylitis were identified who were evaluated by the senior author in the years 1990\u20132008. The most common presenting symptoms were neck pain (37.5%), cranial neuropathy (37.5%), and sensory disturbance (62.5%). On examination, the most common findings were limited cervical range of motion (37.5%), weakness (50%), and myelopathy (75%). Radiographic evaluation revealed atlantoaxial subluxation, retroodontoid pannus formation, basilar invagination, and bone erosion. Surgery was offered to all of the patients, 7 of whom underwent operations. In most cases, the treatment was transoral\u2013transpalatopharyngeal decompression followed by occipitocervical fusion. One patient with a reducible lesion underwent dorsal fusion alone. Neurological outcomes were favorable overall.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The incidence of CVJ disease in patients with ankylosing spondylitis varies among reports. These cases are rare in most neurosurgery clinics. It is important to recognize that patients with ankylosing spondylitis are at risk for CVJ disease, similar to patients with rheumatoid arthritis. Principles common to the management of other CVJ pathologies apply to these patients as well.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.11.spine10279","type":"journal-article","created":{"date-parts":[[2011,2,4]],"date-time":"2011-02-04T14:54:35Z","timestamp":1296831275000},"page":"429-436","source":"Crossref","is-referenced-by-count":22,"title":["Ankylosing spondylitis of the craniovertebral junction: a single surgeon's experience"],"prefix":"10.3171","volume":"14","author":[{"given":"Gregory W.","family":"Albert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold H.","family":"Menezes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine10279","series-title":"Arthritis Rheum","doi-asserted-by":"publisher","first-page":"2845","DOI":"10.1002\/art.22060","article-title":"Immunohistologic analysis of zygapophyseal joints in patients with ankylosing spondylitis","volume":"54","author":"Appel","year":"2006"},{"key":"b2-spine10279","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1016\/S0140-6736(07)60635-7","article-title":"Ankylosing spondylitis","volume":"369","author":"Braun","year":"2007"},{"key":"b3-spine10279","series-title":"Eur J Pediatr","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1007\/s00431-005-1651-x","article-title":"Spontaneous atlantoaxial subluxation as a presenting manifestation of juvenile ankylosing spondylitis in a female HLA-B27-negative patient","volume":"164","author":"Breda","year":"2005"},{"key":"b4-spine10279","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.2106\/00004623-200507000-00023","article-title":"Atlantoaxial rotatory dislocation with hypoglossal nerve palsy in a patient with ankylosing spondylitis. A case report","volume":"87","author":"Chien","year":"2005"},{"key":"b5-spine10279","series-title":"Am J Phys Med Rehabil","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1097\/00002060-200212000-00012","article-title":"Ankylosing spondylitis manifested by spontaneous anterior atlantoaxial subluxation","volume":"81","author":"Chou","year":"2002"},{"issue":"1 Suppl","key":"b6-spine10279","series-title":"J Neurosurg","first-page":"149","article-title":"Spondyloarthropathy-induced atlantoaxial collapse. Case illustration","volume":"97","author":"Das","year":"2002"},{"key":"b7-spine10279","series-title":"J Rheumatol","first-page":"1668","article-title":"Cervical cord compression complicating atlantoaxial subluxation in ankylosing spondylitis","volume":"23","author":"Dellestable","year":"1996"},{"key":"b8-spine10279","series-title":"Br Med J (Clin Res Ed)","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1136\/bmj.287.6392.585-a","article-title":"Non-reducible rotational head tilt in ankylosing spondylitis","volume":"287","author":"Finch","year":"1983"},{"key":"b9-spine10279","series-title":"Injury","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/0020-1383(87)90141-0","article-title":"Fracture of the dens in ankylosing spondylitis","volume":"18","author":"Govender","year":"1987"},{"key":"b10-spine10279","series-title":"Arch Intern Med","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1001\/archinte.1983.00350030085015","article-title":"Nonreducible rotational head tilt and atlantoaxial lateral mass collapse. Clinical and roentgenographic features in patients with juvenile rheumatoid arthritis and ankylosing spondylitis","volume":"143","author":"Halla","year":"1983"},{"key":"b11-spine10279","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2344","DOI":"10.1097\/00007632-199311000-00037","article-title":"Atlantoaxial dislocation as the presenting symptom of ankylosing spondylitis","volume":"18","author":"Hamilton","year":"1993"},{"key":"b12-spine10279","series-title":"J Laryngol Otol","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1017\/S0022215107007608","article-title":"Anterior fracture dislocation of the odontoid peg in ankylosing spondylitis as a cause for rhinolalia clausa: a case study","volume":"122","author":"Hilton","year":"2008"},{"key":"b13-spine10279","series-title":"Arthritis Rheum","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1002\/art.1780300718","article-title":"Atlantoaxial subluxation in juvenile ankylosing spondylitis","volume":"30","author":"Kernodle","year":"1987"},{"key":"b14-spine10279","series-title":"J Am Med Assoc","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1001\/jama.1952.02930220021008","article-title":"Non-traumatic cervical dislocations in rheumatoid spondylitis","volume":"149","author":"Kornblum","year":"1952"},{"key":"b15-spine10279","series-title":"Rev Rhum Engl Ed","first-page":"455","article-title":"Spontaneous fracture of the odontoid process in a patient with ankylosing spondylitis. Nonunion responsible for compression of the upper cervical cord","volume":"62","author":"Kremer","year":"1995"},{"key":"b16-spine10279","series-title":"Clin Rheumatol","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1007\/s100670170041","article-title":"Radiologic changes of cervical spine in ankylosing spondylitis","volume":"20","author":"Lee","year":"2001"},{"key":"b17-spine10279","series-title":"Clin Exp Rheumatol","first-page":"331","article-title":"Cervical spine involvement in longstanding ankylosing spondylitis","volume":"23","author":"Lee","year":"2005"},{"key":"b18-spine10279","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1097\/00007632-199012000-00028","article-title":"Atlantoaxial rotary subluxation in ankylosing spondylitis. A case report","volume":"15","author":"Leventhal","year":"1990"},{"key":"b19-spine10279","series-title":"Am J Med","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/0002-9343(76)90438-1","article-title":"Upward subluxation of the axis in ankylosing spondylitis. A clinical pathologic report","volume":"60","author":"Little","year":"1976"},{"key":"b20-spine10279","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1212\/WNL.5.4.290","article-title":"Spontaneous dislocation of the atlantoaxial joint in rheumatoid spondylitis; recovery from quadriplegia following surgical decompression","volume":"5","author":"Margulies","year":"1955"},{"key":"b21-spine10279","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"223","article-title":"The occipito-atlanto-axial joints in rheumatoid arthritis and ankylosing spondylitis","volume":"86","author":"Martel","year":"1961"},{"key":"b22-spine10279","series-title":"Arthritis Rheum","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1002\/art.1780030608","article-title":"Cervical vertebral erosions and subluxations in rheumatoid arthritis and ankylosing spondylitis","volume":"3","author":"Martel","year":"1960"},{"key":"b23-spine10279","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1007\/s00381-008-0604-x","article-title":"Decision making","volume":"24","author":"Menezes","year":"2008"},{"key":"b24-spine10279","series-title":"J Rheumatol","first-page":"771","article-title":"Fractures of the dens complicating ankylosing spondylitis with atlantooccipital fusion","volume":"18","author":"Miller","year":"1991"},{"issue":"1","key":"b25-spine10279","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E6","DOI":"10.3171\/FOC\/2008\/24\/1\/E6","article-title":"Complications of the spine in ankylosing spondylitis with a focus on deformity correction","volume":"24","author":"Mundwiler","year":"2008"},{"key":"b26-spine10279","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1038\/sj.sc.3100926","article-title":"Odontoid fracture complicating ankylosing spondylitis","volume":"38","author":"Ozgocmen","year":"2000"},{"key":"b27-spine10279","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1097\/00005373-199503000-00009","article-title":"Fracture of the odontoid peg in ankylosing spondylitis: case report","volume":"38","author":"Peh","year":"1995"},{"key":"b28-spine10279","series-title":"J Fac Radiol","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/S0368-2242(59)80010-5","article-title":"Spontaneous dislocation of the atlanto-axial articulation occurring in ankylosing spondylitis and rheumatoid arthritis","volume":"10","author":"Pratt","year":"1959"},{"key":"b29-spine10279","series-title":"J Rheumatol","first-page":"2120","article-title":"Frequency of atlantoaxial subluxation and neurologic involvement in patients with ankylosing spondylitis","volume":"22","author":"Ramos-Remus","year":"1995"},{"key":"b30-spine10279","series-title":"J Rheumatol","first-page":"507","article-title":"Two year follow-up of anterior and vertical atlantoaxial subluxation in ankylosing spondylitis","volume":"24","author":"Ramos-Remus","year":"1997"},{"key":"b31-spine10279","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/S0022-3476(78)81190-1","article-title":"Atlantoaxial subluxation in juvenile ankylosing spondylitis","volume":"93","author":"Reid","year":"1978"},{"key":"b32-spine10279","series-title":"Ann Rheum Dis","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1136\/ard.20.1.47","article-title":"Spontaneous atlanto-axial dislocation in ankylosing spondylitis and rheumatoid arthritis","volume":"20","author":"Sharp","year":"1961"},{"key":"b33-spine10279","series-title":"J Rheumatol","first-page":"2464","article-title":"Multiple cerebellar infarction due to vertebral artery obstruction and bulbar symptoms associated with vertical subluxation and atlanto-occipital subluxation in ankylosing spondylitis","volume":"25","author":"Shim","year":"1998"},{"key":"b34-spine10279","series-title":"Arthritis Rheum","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1002\/art.1780220309","article-title":"Atlantoaxial subluxation as a complication of early ankylosing spondylitis. Two cases reports and a review of the literature","volume":"22","author":"Sorin","year":"1979"},{"key":"b35-spine10279","series-title":"J Rheumatol","first-page":"973","article-title":"Anterior atlantoaxial subluxation in patients with spondyloarthropathies: association with peripheral disease","volume":"15","author":"Suarez-Almazor","year":"1988"},{"key":"b36-spine10279","series-title":"Spine","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1097\/00007632-198200710-00014","article-title":"Spontaneous atlantoaxial subluxation as a presenting manifestation of juvenile ankylosing spondylitis. A case report","volume":"7","author":"Thompson","year":"1982"},{"key":"b37-spine10279","series-title":"Br J Rheumatol","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1093\/rheumatology\/36.2.293","article-title":"Atlantoaxial subluxation in an ankylosing spondylitis patient with cervical spine ossification","volume":"36","author":"Toussirot","year":"1997"},{"key":"b38-spine10279","series-title":"Ann Rheum Dis","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1136\/ard.17.2.209","article-title":"Clinical features and course of ankylosing spondylitis; as seen in a follow-up of 222 hospital referred cases","volume":"17","author":"Wilkinson","year":"1958"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/14\/4\/article-p429.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/14\/4\/article-p429.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/14\/4\/article-p429.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T22:09:44Z","timestamp":1681596584000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/14\/4\/article-p429.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2011,4]]},"references-count":38,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2010.11.spine10279","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2011,4]]}}}