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Journal of Korean Neurosurgical Society 1997;26(7): 934-939.
Surgical Management of Atlantoaxial Instability Due to Rheumatoid Arthritis.
Gyu Seok Lee, Seong Hoon Oh, Seong Yoon Kim, Young Soo Kim, Yong Ko, Suck Jun Oh, Kwang Myung Kim, Nam Kyu Kim
Department of Neurosurgery, Hanyang University, School of Medicine, Seoul, Korea.
Rheumatoid arthritis can lead to joint deformity and loss of functional capacity. The cervix may be involved, and this was first described by Garrod, in 1890. The most common abnormalities of the cervical spine found in rheumatoid arthritis patients are atlantoaxial and subaxial subluxation, and superior migration of the odontoid, the incidence of atlantoaxial subluxation is reported to be 19-17%. When signs and symptoms of spinal cord compression occur, operative stabilization is clearly indicated. Early operative fusion before evidence of appreciable neural compression occurs, is frequently recommended. Internal fixation typically involves a bone graft with Gallie-type, Brooks-type, or Dickman's interspinous fusion, or transarticular screw fixation. The purpose of this report is to describe the surgical procedures available for treatment of the rheumatoid cervical spine, the indications for surgical intervention, operative techniques, and the results in 11 patients.
Key Words: Rheumatoid arthritis; Atlantoaxial subluxation; Transarticular screw fixation
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