Operations for the unstable cervical spine in rheumatoid arthritis |
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Authors: | Seppo Santavirta Yrj T. Konttinen Jerker Sandelin P r Sl tis |
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Affiliation: | a Orthopedic Hospital of the Invalid Foundation,b Fourth Department of Medicine, University Central Hospital, Helsinki, Finland |
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Abstract: | Sixteen patients with seropositive rheumatoid arthritis were operated on for subaxial subluxations. Four of the patients had slight, but progressive, tetraparesis, and 5 had severe or total tetraparesis; they were operated on 1-4 months after the first signs. Seven patients were treated for severe neck and shoulder pain. Nine patients had subluxation at the C3-4 level, the most common site, and 3 patients also had an atlantoaxial subluxation. Patients with cord compression were treated with posterior laminectomies and fusions that relieved the tetraparesis. Two patients died during the early postoperative period: 1 of a cardiac infarction and the other of pneumonia. During 4 (1.5-9) years' follow-up, 3 patients had new subluxations at other levels. |
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