PMID: 9174444Apr 1, 1997Paper

Subaxial cervical spine subluxation in rheumatoid arthritis. A retrospective analysis of 16 operated patients after 1-5 years

Acta Orthopaedica Scandinavica
C OlerudM Rodriguez

Abstract

We evaluated the clinical and radiological outcomes in 16 patients (15 women) having rheumatoid arthritis with a mean age of 66 (55-77) years, on average 2 (1-5) years after decompression and stabilization, for subaxial subluxation of the cervical spine. The duration of rheumatoid arthritis averaged 30 (10-67) years and the duration of neck symptoms averaged 15 (1-60) months. Preoperatively, 11 of the patients had pain in the neck, all 16 suffered from arm rhizopathy and varying degrees of myelopathy. 4/5 patients with severe myelopathy died within 3 months of surgery. Fixation failure occurred in 7 patients, but had no clinical significance in 5. There were 1 deep infection and 1 nerve root lesion resulting in deltoid weakness. Other complications were dysphagia and donor-site pain. 4 reoperations were performed, 2 extension of fusion, 1 revision of infection, and 1 foraminotomy. Neck pain was reliably relieved, while arm rhizopathy was less positively affected. Myelopathy carried a poor prognosis for relief and its occurrence correlated with death. Early treatment, before significant myelopathy has developed, is recommended. Decompression, both via realignment and bone resection, followed by fusion of the entire cervical spin...Continue Reading

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Citations

Mar 21, 2007·International Orthopaedics·M Schmitt-SodyA Veihelmann
Jul 21, 2004·Journal of Spinal Disorders & Techniques·Yoshio SudaKeiichi Shibasaki
Jan 13, 2010·Journal of Spinal Disorders & Techniques·Kenichi HiranoNaoki Ishiguro
Jul 16, 2003·Journal of Neurosurgery·Masakazu TakayasuJun Yoshida
Jan 30, 2004·Journal of Neurosurgery·Yoshihiro MukaiHideki Yoshikawa
Jul 28, 1999·Upsala Journal of Medical Sciences·C OlerudB Sahlstedt
Oct 23, 2002·The Orthopedic Clinics of North America·Adrian T H CaseyJohn M Stevens
Apr 5, 2016·Neurologia Medico-chirurgica·Masakazu TakayasuMikinobu Takeuchi
Mar 29, 2005·Neurosurgery·Ravindra NannapaneniNicholas V Todd
Nov 8, 2005·The Journal of the American Academy of Orthopaedic Surgeons·David H Kim, Alan S Hilibrand
Oct 11, 2020·Neurosurgical Review·Nathan A Shlobin, Nader S Dahdaleh

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