Article Text

Learning from errors
Fatality from minor cervical trauma in ankylosing spondylitis
  1. Thorleif Etgen1,2,
  2. Georg Rieder1
  1. 1
    Klinikum Traunstein, Department of Neurology, Cuno-Niggl-Str. 3, Traunstein, 83278, Germany
  2. 2
    Technische Universität München, Department of Psychiatry and Psychotherapy, Ismaninger Strasse 22, München, 81675, Germany
  1. Thorleif Etgen, thorleif{at}


Cervical injury is a serious and often fatal complication of ankylosing spondylitis in the setting of minor trauma. This case report describes a 51-year-old woman with ankylosing spondylitis and a minor trauma who developed severe bradycardia during positioning for x ray. Further diagnostic revealed a hyperextensive fracture of C4 with fragments compressing the cervical medulla. The woman subsequently died from hypoxic brain damage. Reviewing the literature, a high alertness in ankylosing spondylitis and minor trauma with neck immobilisation is emphasised, early diagnosis using cervical spine computed tomography is essential to a favourable outcome, and the mechanism of bradycardia in cervical trauma is discussed.

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  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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