Occipito-cervical fusion reinforced by Luque's segmental spinal instrumentation for rheumatoid diseases

Thirteen rheumatoid patients who suffered from severe neck-occipital pain with or without myelopathy due to cranio-cervical instability, were operated on using a modified U-shaped rod. Twelve of them concomitantly had lower cervical rheumatoid lesions. Average extent of fusion was 5.9 levels. Bone union was confirmed in twelve cases in which autogenous bone graft had been used at approximately 4 months postoperatively; methylmethacrylate was used in the remaining one case. Good alignment of the cervical spine also was obtained in 12 cases; one patient experienced occipito-C2 shortening after an additional surgery for deep infection. Improvement of neck-occipital pain was noted in all cases, and seven of eight patients with myelopathy showed neurologic recovery.