Cervical spine instability and canal stenosis caused by rheumatoid arthritis

Neurologico Spinale Medico Chirurgico

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Title Cervical spine instability and canal stenosis caused by rheumatoid arthritis
Creator Subagio, Eko Agus
Kim, Seok Woo
Subject Reumatoid arthritis
Atlantoaxial instability
Sub-axial subluxation
Cervical canal stenosis
Description Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that impacts on weakening ligaments, synovial arthritis and cartilage damage. The effect that can occur is instability and neural compression in the upper and sub-axial cervical. The prevalence of atlantoaxial instability (AAI) is around 40-80% among rheumatoid patients, but it is interesting to examine the clinical symptoms that are not so visible despite radiological instability confirmed on the cervical spine. However, once the clinical symptoms of myelopathy occur, the mortality rate will increase sharply.
We report a case of a 66-years old female who was admitted to our hospital with gait disturbance and weakness of her lower extremities. Radiographic evaluation of the cervical spine showed erosive destruction of the odontoid process of C2, anterior atlantoaxial subluxation, and thickened yellow ligaments from C3 to C7. Surgery was performed by removal of the posterior arch of C1 and laminectomy C3 to C7, posterior occipito-cervical screw fixation from C3 to C7, combined with atlantoaxial transpedicular screw fixation. A sterno sub-occipitomandibular immobilization (SOMI) orthosis was applied for postoperative immobilization for 12 weeks. Improvement of motoric status noted after surgery.
Publisher Indoscholar
Date 2020-11-03
Type info:eu-repo/semantics/article
Format application/pdf
Identifier https://nsmc.indoscholar.com/index.php/nsmc/article/view/115
Source Neurologico Spinale Medico Chirurgico; Vol 3 No 3 (2020); 97-102
Language eng
Relation https://nsmc.indoscholar.com/index.php/nsmc/article/view/115/100
Rights Copyright (c) 2020 Neurologico Spinale Medico Chirurgico

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