Introduction: Ankylosing spondylitis (AS) predisposes patients to unstable spinal fractures due to spinal rigidity and osteoporosis, often complicated by severe kyphotic deformity. Case Report: A 56-year-old man with AS presented with neck pain after a trivial fall. He had severe thoracic kyphosis, a rigid spine, and impaired horizontal gaze. Neurological examination was normal. Diagnosis, Intervention, and Outcomes: Computed tomography and magnetic resonance imaging revealed an AO Type B2, N0, M3 fracture at C7 in a fused spine. A thoracic vertebral column resection (D5) with long posterior instrumentation was performed to achieve both fracture stabilization and sagittal alignment correction. Postoperatively, the patient demonstrated improved horizontal gaze and standing balance. At 2-year follow-up, correction was maintained without complications. Conclusion: Remote thoracic osteotomy can stabilize cervical fractures in AS while correcting global sagittal alignment. This approach offers a safe and effective alternative to traditional site-focused strategies. Keywords: Ankylosing spondylitis, cervical spine fracture, thoracic osteotomy, vertebral column resection, sagittal balance.
Rout et al. (Thu,) studied this question.