Systematic review and meta-analysis on comparing treatment approaches of cervical fractures in ankylosing spondylitis to determine improvement in outcomes.

What was studied

This review compared surgery routes for neck fractures in ankylosing spondylitis. The routes were from the front, from the back and both. Doctors debate which is better. The choice often rests on surgeon skill and patient factors. The review looked at complications, nerve recovery and death. It searched many databases from 1970 to 2025. It pooled retrospective studies.

What they found

The review covered 1441 patients. Most were male. Method quality was poor across all studies. One comparison was significant. The front route had more complications than the back route. The odds ratio was 2.97. Nerve recovery did not differ in any comparison. Death rates did not differ either. Tests showed no sign of publication bias.

What it means for patients

The authors say the back route appears favorable for fewer complications. This is based on low-certainty evidence. They say it should not override individual surgical decisions. These rest on the fracture, nerve status and surgeon skill. They say prospective multicenter studies are needed.

Why it is not certain yet

All studies were retrospective. Method quality was poor. Results varied a lot between studies on nerve recovery. The authors call the evidence low-certainty. Only one comparison reached significance.

Source

Systematic review and meta-analysis on comparing treatment approaches of cervical fractures in ankylosing spondylitis to determine improvement in outcomes.

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