Ankylosing Spondylitis with 3 Column Cervical spine fracture This 72 year old male presented to us with History of fall 15 days back and complaints of neck pain. for last 3 days weakness in rt side of his body and had difficulty in walking and standing. His Xray showed fracture through three columns of spine. MRI showed OPLL and cord oedema. Patient underwent posterior long segment fixation with Lateral mass screw and pedicle screw and laminectomy. Patient was mobilised after 2 days and discharged. Any Patient with Ankylosing spondylitis with history of fall and back pain should undergo MRI to rule out fractures. Any fracture in Ankylosing Spondylitis should always undergo pedicle screw fixation as the fractures in these patients has very high tendency for non union , displacement and Neurological deficit.