title: Operations for the unstable cervical spine in rheumatoid arthritis. Sixteen cases of subaxial subluxation.
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.
authors.affiliation: Orthopedic Hospital, Invalid Foundation, Helsinki, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Santavirta
authors.forename: Y T
authors.initials: YT
authors.lastname: Konttinen
authors.forename: J
authors.initials: J
authors.lastname: Sandelin
authors.forename: P
authors.initials: P
authors.lastname: Slätis
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D005684:Gait; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D004204:Joint Dislocations / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology; D012086:Reoperation; D013123:Spinal Fusion