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Occipitocervical fusion for rheumatoid arthritis using the inside-outside stabilization technique
Faheem A Sandhu1, T Glenn Pait, Edward Benzel
1Department of Neurosurgery, Georgetown University, Washington, DC 20007, USA.
Spine
|February 19, 2003
Summary
The inside-outside cranial bolt technique effectively stabilizes the occipitocervical junction in rheumatoid arthritis patients, significantly reducing neck pain and improving neurological function without complications.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Rheumatology
Background:
- Occipitocervical fusion in rheumatoid arthritis presents significant challenges.
- Complications associated with traditional occipital screw placement are a concern.
Purpose of the Study:
- To evaluate the safety and efficacy of the inside-outside cranial bolt technique for occipitocervical stabilization.
- To assess outcomes in rheumatoid arthritis patients undergoing this procedure.
Main Methods:
- A retrospective study of 21 rheumatoid arthritis patients undergoing occipitocervical stabilization.
- Utilized the inside-outside technique with bilateral fixation of cervical plates to the occiput and cervical spine.
- Assessed pre- and postoperative neurologic status, neck pain, fusion, alignment, and hardware complications.
Main Results:
- No surgical complications were reported in any patient.
- Significant reduction in neck pain (Ranawat pain score P < 0.0001).
- Improved neurologic grade in 62% of patients; no further cranial settling observed.
Conclusions:
- The inside-outside technique is a safe and effective method for occipitocervical stabilization in rheumatoid arthritis.
- The procedure leads to substantial improvements in pain and neurological function.
- It ensures maintenance of spinal alignment and stability without implant complications.