Non-neoplastic bone destruction, known as Andersson lesion, is not rare in ankylosing spondylitis (AS) and always appeared as bone destruction and sclerosis in the vertebral body-intervertebral disc region. The Andersson lesion has been reported mostly in the thoracic and lumbar spine and rarely in the lower cervical spine. We surgically treated a patient with AS complicated with atlantoaxial dislocation and destruction of dens and lateral atlantoaxial joint, which was similar to the Andersson lesion.
AS can cause destructive lesion in the upper cervical spine. Posterior reduction, removal of the lesion, and fusion were possible approaches for the treatment of this destructive lesion.