Osteotomies for the Treatment of Cervical Kyphosis Caused by Ankylosing Spondylitis: Indications and Techniques

Ankylosing spondylitis is an inflammatory disorder that can produce disabling musculoskeletal conditions. Spinal deformity is among the most common manifestations. Cervical kyphosis can be particularly debilitating to the patient because of interference with forward gaze and activities of daily living. In addition, cervical deformity can lead to both neurologic and respiratory deterioration. For many patients, the only treatment option is surgery. Both the Smith-Petersen osteotomy and the pedicle subtraction osteotomy have been used successfully to manage cervical deformity in patients with ankylosing spondylitis. These procedures are technically difficult and carry significant risk but can produce excellent and safe outcomes.