PMID: 8596154Nov 1, 1995Paper

Frequency of atlantoaxial subluxation and neurologic involvement in patients with ankylosing spondylitis

The Journal of Rheumatology
C Ramos-RemusM E Suarez-Almazor

Abstract

To determine the prevalence of anterior and vertical atlantoaxial subluxation (AAS) and its neurological effect in a consecutive sample of Mexican patients with ankylosing spondylitis (AS). Consecutive patients with a diagnosis of AS who attended 2 secondary care outpatient rheumatology clinic in the city of Guadalajara within a period of 6 mo were included in the study. Patients had prospective rheumatologic and neurologic assessments using structured questionnaires and examinations. Recorded variables included demographic data, disease characteristics, neurologic symptoms and signs, and axial mobility measurements. Somatosensory evoked potentials (SSEP) were performed in all patients. Patients also underwent standard cervical spine radiography with anteroposterior open mouth, and neutral, full flexion and extension lateral views. We studied 103 patients. Mean age was 35 yrs, 74% were male, and mean disease duration was 10 yrs (S/- SD 7.9). Anterior AAS was observed in 22 patients (21%, 95% CI 13-29%) and vertical AAS in 2 cases (2%, 95% CI 0-7%). Ossification of the posterior longitudinal ligament (OPLL) was present in 16 patients. Statistically significant associations were observed between anterior AAS and SSEP (p < 0.0001)...Continue Reading

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