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Brain-stem compression in rheumatoid arthritis.

R C Davidson, J R Horn, J H Herndon

    JAMA
    |December 12, 1977
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    Vertical subluxation of the upper cervical spine (C-1 to C-2) can cause dysphagia. Transpharyngeal resection of the odontoid process effectively relieved symptoms in a rheumatoid arthritis patient.

    Area of Science:

    • Orthopedics
    • Rheumatology
    • Neurosurgery

    Background:

    • Cervical spine instability is a common complication of rheumatoid arthritis.
    • Vertical subluxation at the C-1 to C-2 level can lead to significant neurological and functional deficits.

    Observation:

    • A patient with rheumatoid arthritis presented with C-1 to C-2 subluxation and dysphagia.
    • Initial treatment with a halo cast and posterior fusion provided temporary symptom relief.

    Findings:

    • Recurrence of symptoms necessitated further intervention.
    • Transpharyngeal resection of the odontoid process resulted in sustained symptom alleviation at 18-month follow-up.

    Implications:

    • This case highlights the potential for recurrent instability after initial surgical management.

    Related Experiment Videos

  • Transpharyngeal odontoidectomy is a viable treatment option for persistent vertical C-1 to C-2 subluxation in rheumatoid arthritis.
  • Emphasizes the importance of considering vertical subluxation in the management of rheumatoid cervical arthritis.