1. Concomitant cervical and thoracic spine fractures are reported in a patient with advanced ankylosing spondylitis (second reported case). 2. The thoracic T9-10 interspace fracture-dislocation was grossly unstable, as well as the C7-T1 fracture-dislocation. 3. The higher incidence of cord injury following spinal fracture-dislocations in these patients is discussed. 4. The dangers of inadequate postinjury immobilization in those patients fortunate enough to be neurologically intact following spinal fracture are stressed.