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Rheumatoid atlantoaxial instability treated by anterior transarticular C1-C2 fixation. Case report
1Klinika Neurochirurgii i Chirurgii Nerwów Obwodowych, Uniwersytet Medyczny w £odzi, ul. Żeromskiego 113, 90-549 Łódź, Polska. krzysztofzapalowicz1@wp.pl
Neurologia I Neurochirurgia Polska
|July 4, 2013
Summary
Anterior transarticular screw fixation effectively treated cervical spine instability in a rheumatoid arthritis patient. This surgical approach provided successful C1-C2 stabilization, allowing the patient to return to work.
Area of Science:
- Orthopedics
- Rheumatology
- Neurosurgery
Background:
- Rheumatoid arthritis can cause severe cervical spine instability.
- Atlantoaxial instability presents with neck pain and limited motion.
Observation:
- A 35-year-old female with rheumatoid arthritis experienced headache and neck pain.
- MRI revealed C1 anterior displacement and atlantoaxial joint destruction.
- Dynamic radiographs confirmed significant C1-C2 instability.
Findings:
- Anterior transarticular screw fixation was successfully performed using a right anterolateral approach.
- Titanium cannulated compressive screws achieved C1-C2 stabilization.
- Four-month follow-up showed successful joint stabilization.
Implications:
- Anterior transarticular screw fixation is a viable option for rheumatoid arthritis-related cervical instability.
- This technique offers satisfactory outcomes despite potential motion restriction.
- Successful surgical stabilization can improve quality of life and return to work.
