[Atlanto-dentoid dislocation in chronic polyarthritis. Correlation of clinical, roentgenological, neurological and...

The involvement of the cervical spine in rheumatoid arthritis especially after prolonged steroid medication, is one of the most dangerous symptoms of this disease. 62 patients suffering from rheumatoid arthritis of the cervical spine underwent a critical examination regarding clinical signs and neurological symptoms. According to Larsen Theses of the radiological grading of the severity of rheumatoid arthritis, we tried to develop a classification of the involvement of the upper and the low cervical spine. Clinical and neurological signs are then found especially in stadium III and IV. The bony ankylosis (stadium V) must be considered as a spontaneous healing, for all clinical and neurological signs will have vanished. Electromyographical observations showed characteristic patterns for each stadium. According to this classification the conservative and the operative treatment can be chosen.