[Indications, problems and results of dynamic compression spondylodesis in rheumatic atlanto-axial instability]

37 patients suffering from rheumatoid atlanto-axial dislocation underwent operations with the dynamic compression spondylodesis from 1982 until 1990 at the Department of Neurosurgery of the University Hospital of Giessen and Essen. They were examined with an average of 2 years after the operation. The clinical and radiological follow up and the complications are reported. Because of the results the indication of the surgical treatment was modified. In the case of an extended peridental inflammatory pannus with osteolysis of the dens and vertical dislocation of the axis a occipito-cervical fusion is indicated.