Cervical spine trauma is more common in patients with ankylosing spondylitis due to a rigid spine, poor balance, and osteoporosis. Injuries are serious with high mortality rates of 35-50% occurring from hyperextension mechanisms. Upper cervical injuries have increased risks of fractures of the odontoid process and transverse ligament due to joint destruction and ossification. Management involves traction and halo vest or internal fixation. Subaxial injuries below C3-C6 disrupt all spinal elements and have increased risks of neurological injury. Treatment requires traction, halo vest, or anterior and posterior fixation spanning two levels above and below the injury. Thoracic fractures are difficult to immobilize and require surgical alignment