[Atloaxoid dislocation in chronic inflammatory rheumatism. Results of 16 occipitoaxoid arthrodeses]

Sixteen cases of spontaneous dislocation of the atlanto-axial joint have been reviewed, fifteen in rheumatoid arthritis and one in ankylosing spondylitis. On four occasions there was some neurological impairment, but in eleven there was only pain and stiffness. The only case of ankylosing spondylitis was operated on after failure of conservative treatment. Three patients died between one and eight months after operation, two of them having had severe neurological impairment before operation. In the thirteen other cases, the average follow up was four years. All had satisfactory fusion after grafting from the skull to axis. Six had only a partial reduction of the displacement and united with some displacement of about 5 mm. The results were satisfactory with absence of pain and regression of neurological signs.