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Erosions of vertebral bodies and intervertebral discs are usually considered as late manifestations of ankylosing spondylitis. Yet they may occur early and indeed constitute the first sign of the disease. This is illustrated by the case reported here, where a 19-year-old woman with an 18-months diagnosis of ankylosing spondylitis was found to have severe destructive lesions of the 6th cervical vertebra without discal lesion nor cervical ankylosis. Surgical biopsy excluded a tumoral or infectious process. Spinal fusion (C4-C7) was performed, and cervical pain was completely relieved with non-steroidal anti-inflammatory drugs.
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