A R EVİ E W OF RHEUMATOID CERVICAL INSTABILITIES REÛUIRING SURGERY INCLUDING NEWER FIXATION METHODS
Journal Title: Journal of Turkish Spinal Surgery - Year 1995, Vol 6, Issue 1
Abstract
Study Design: 50 rheumatoid patients requiring cervical spine surgery for irıstabilities were retrospectively reviewed. Objectives: A retrospective revievj of our patient population and surgical outcome to determine if utilizing Standard wiring procedures are comparable to previously published reports. Summary of Background Data: Cervical spine instability has been shown to occur early in the course of rheumatoid disease (6, 45, 46, 48, 49). The instability produced, combined with proliferation of synovitic tissue (pan-nus), may compress the spinal cord, nerve roots, and vertebral arteries resulting in pain and neurological abnor-malities. Primary treatment in rheumatoid arthritis of the spine is directed towards prevention of neural compro-mise and for this reason surgical arthrodesis is advised when instability is present. Results: 27 patients had sufficient documentation for inclusion. Some had newer methods of fixation includ-ing plates and screws. Mean follow-up vvas 28 months. Our series demonstrated similar outcome for wiring procedures with 81% bony fusion rate and no neurological deterioration. 11% developed subaxial instability following upper cervical spine procedures. Conclusions: Newer methods of fixation were helpful in treating more complicated cases including multilevel involvements, deformity and higher grade instability.
Authors and Affiliations
Chester E. SUTTERLIN, O. Richard SINGER, Merril W. REUTER, Gary L. LOVVERY, Glenn R. RECHTINE
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