Related Experiment Videos
Atlantoaxial stabilization in rheumatoid arthritis
S M Papadopoulos1, C A Dickman, V K Sonntag
1Section of Neurosurgery, University of Michigan, Ann Arbor.
Journal of Neurosurgery
|January 1, 1991
Summary
Early surgical fusion for rheumatoid arthritis patients with mobile atlantoaxial subluxation over 6 mm may prevent irreversible myelopathy and sudden death. This approach is recommended for healthier patients under 65.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Spinal Surgery
Background:
- Atlantoaxial subluxation is a frequent complication in rheumatoid arthritis.
- Surgical stabilization is indicated for spinal cord compression, but early intervention is debated.
Observation:
- This study presents 17 rheumatoid arthritis patients with atlantoaxial subluxation treated with posterior arthrodesis.
- Indications included spinal cord compression (65%) or mobile subluxation >6 mm without symptoms (35%).
Findings:
- A novel fusion technique was used, achieving osseous fusion in 13 patients and fibrous union in three.
- One patient died before fusion evaluation. Technical advantages are noted for rheumatoid arthritis patients.
Implications:
- Consider early operative stabilization for rheumatoid arthritis patients with mobile atlantoaxial subluxation >6 mm, especially if under 65 and in good health.
- This may prevent irreversible neurological deficits and improve outcomes in this challenging patient population.