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ATLANTO-AXIAL SUBLUXATION IN RHEUMATOID ARTHRITIS

N. A. Rana 1; D. O. Hancock 2; A. R. Taylor 2; ; and A. G. S. Hill 2

1 Stoke Mandeville Hospital, Aylesbury; Chicago, United States of America
2 Stoke Mandeville Hospital, Aylesbury; Buckinghamshire, England

1. This paper presents the neurological findings in forty-one patients with rheumatoid arthritis complicated by atlanto-axial subluxation.

2. A method of radiological measurement of the subluxation is described. The extent of neurological involvement was found not to correspond with the degree of subluxation.

3. Fusion of the atlanto-axial complex or of the occipito-atlanto-axial complex is indicated only in patients with progressive neurological signs and in those suffering from acute neurological episodes.

4. Difficulty in obtaining fusion with cancellous bone grafts alone was encountered and we recommend wiring of the laminae C.1 to C.2 in addition.
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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General