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A stiff collar can restrict atlantoaxial instability in rheumatoid cervical spine in selected cases
Objective:
To study the efficiency of a stiff collar in restricting the instability of anterior atlantoaxial subluxation (AAS).
Methods:
Twenty two successive patients with an unstable AAS were studied. Lateral view radiographs were taken of the cervical spine in flexion, extension, and neutral positions without a collar, and in full flexion with a custom made stiff collar.
Results:
The collar restricted more than 30% of the maximal instability of the AAS in 50% of the patients. These patients had significantly shorter atlantoaxial distance in the neutral position than those in whom the collar was not able to restrict the instability.
Conclusion:
A stiff collar can restrict the atlantoaxial instability in selected rheumatic patients with an unstable AAS. Lateral view radiographs of the cervical spine in a neutral position can be used to identify the patients whom the collar will benefit.