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Headmaster collar restricts rheumatoid atlantoaxial subluxation
M Kauppi1, M H Neva, H Kautiainen
1Rheumatism Foundation Hospital, Heinola, Finland. markku.kauppi@reuma.fimnet.fi
Spine
|April 2, 1999
Summary
The Headmaster collar effectively treats rheumatoid atlantoaxial subluxation in many patients. However, a custom-made stiff collar may still be necessary for some, indicating a complementary role for both orthotic devices.
Area of Science:
- Orthopedics
- Rheumatology
- Medical Device Technology
Background:
- Atlantoaxial subluxation is a frequent complication of rheumatoid arthritis, necessitating effective conservative treatments.
- Custom-made stiff collars have demonstrated efficacy in restricting subluxation in about half of affected patients.
Purpose of the Study:
- To evaluate the efficacy of a novel open-type collar, the Headmaster collar, in limiting atlantoaxial subluxation.
Main Methods:
- A radiographic study involving 30 patients with rheumatoid atlantoaxial subluxation.
- Lateral view radiographs were obtained in neutral, flexion, and extension positions, both with and without the Headmaster collar.
Main Results:
- The Headmaster collar significantly reduced atlantoaxial distance during flexion in patients with the greatest stabilizing effect (1.1 +/- 1.3 mm).
- A lesser stabilizing effect was observed in patients with pre-existing subluxation in the neutral position (6.7 +/- 2.5 mm).
Conclusions:
- The Headmaster collar is a valuable tool for conservative management of simple unstable atlantoaxial subluxation.
- Both the Headmaster collar and custom-made stiff collars are complementary, requiring individualized selection and application.