{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:17:23Z","timestamp":1781327843268,"version":"3.54.1"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,10]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The treatment of cervical fixed flexion deformity in ankylosing spondylitis presents a challenging problem that is traditionally managed by a corrective cervicothoracic osteotomy. The authors report a new approach to this problem that involves performing a two-level osteotomy at the level of maximum spinal curvature, thereby achieving complete anatomical correction in a one-stage procedure.<\/jats:p>\n<jats:p content-type=\"fine-print\">This 48-year-old woman with ankylosing spondylitis presented with a 30-year history of progressive neck deformity that left her unable to see ahead and caused her to experience difficulty eating, drinking, and breathing on exertion. On examination, she exhibited a 90\u00b0 fixed flexion deformity of the cervical spine, which was maximum at C-4; this was confirmed on imaging studies.<\/jats:p>\n<jats:p content-type=\"fine-print\">A two-level osteotomy was performed at C3\u20134 and C4\u20135 around the area of maximum spinal curvature, and the deformity was corrected by extending the head on its axis of rotation through the uncovertebral joints. The spine was stabilized using a Ransford loop. An excellent anatomical position was achieved, as was complete correction of the deformity.<\/jats:p>\n<jats:p content-type=\"fine-print\">A two-level midcervical osteotomy performed at the level of maximum spinal curvature in ankylosing spondylitis enables complete correction of severe fixed flexion deformity in a single procedure. Preservation of the uncovertebral joints allows smooth and safe correction of the deformity about their axis of rotation.<\/jats:p>","DOI":"10.3171\/spi.2000.93.2.0283","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:49:21Z","timestamp":1241711361000},"page":"283-286","source":"Crossref","is-referenced-by-count":4,"title":["New approach to cervical flexion deformity in ankylosing spondylitis"],"prefix":"10.3171","volume":"93","author":[{"given":"Sarah E.","family":"Duff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"Grundy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven S.","family":"Gill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Can Anaesth Soc J","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1007\/BF03004823","article-title":"Anaesthesia for posterior cervical osteotomy.","volume":"22","author":"Harris","year":"1975"},{"key":"b2","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"291","DOI":"10.2106\/00004623-195941020-00011","article-title":"Vertebral osteotomy for kyphosis, especially in Marie-Strumpell arthritis.","volume":"41","author":"Herbert","year":"1959"},{"key":"b3","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.2106\/00004623-196244060-00018","article-title":"Osteotomy of the spine.","volume":"44","author":"Law","year":"1962"},{"key":"b4","series-title":"Anaesthesia","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1111\/j.1365-2044.1984.tb06496.x","article-title":"Ankylosing spondylitis.","volume":"39","author":"Lloyd","year":"1984"},{"key":"b5","series-title":"Calif Med","first-page":"244","article-title":"Surgical correction of flexion deformity of the cervical spine.","volume":"79","author":"Mason","year":"1953"},{"key":"b6","series-title":"J Bone Joint Surg (Br)","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1302\/0301-620X.79B2.0790197","article-title":"Osteotomy of the cervical spine in ankylosing spondylitis.","volume":"79","author":"McMaster","year":"1997"},{"key":"b7","series-title":"Clin Orthop","first-page":"65","article-title":"Kyphotic deformity of the spine in ankylosing spondylitis.","volume":"128","author":"Simmons","year":"1977"},{"key":"b8","series-title":"Clin Orthop","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1097\/00003086-197207000-00019","article-title":"The surgical correction of flexion deformity of the cervical spine in ankylosing spondylitis.","volume":"86","author":"Simmons","year":"1972"},{"key":"b9","series-title":"J Bone Joint Surg","first-page":"1","article-title":"Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis.","volume":"27","author":"Smith-Petersen","year":"1945"},{"key":"b10","series-title":"J Bone Joint Surg (Am)","doi-asserted-by":"publisher","first-page":"833","DOI":"10.2106\/00004623-195840040-00007","article-title":"Osteotomy of the cervical spine. Report of a case of ankylosing rheumatoid spondylitis.","volume":"40","author":"Urist","year":"1958."},{"key":"b11","series-title":"J Orthop Rheum","first-page":"91","article-title":"Cervical osteotomy for the flexed cervical spine in ankylosing spondylitis.","volume":"9","author":"Weale","year":"1996"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/93\/2\/article-p283.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/93\/2\/article-p283.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/93\/2\/article-p283.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:58:44Z","timestamp":1681606724000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/93\/2\/article-p283.xml"}},"subtitle":["Case report"],"short-title":[],"issued":{"date-parts":[[2000,10]]},"references-count":11,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/spi.2000.93.2.0283","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2000,10]]}}}