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A R EVİ E W OF RHEUMATOID CERVICAL INSTABILITIES REÛUIRING SURGERY INCLUDING NEWER FIXATION METHODS

  • Chester E. SUTTERLIN
  • O. Richard SINGER
  • Merril W. REUTER
  • Gary L. LOVVERY
  • Glenn R. RECHTINE

J Turk Spinal Surg 1995;6(1):19-24

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.

Keywords: Cervical spine, İnstability, Rheumatoid arthritis, Arthrodesis