Posterior decompression and fusion in rheumatoid disease of the cervical spine: redressing the balance.
Forty-seven patients with rheumatoid disease of the cervical spine were followed over an 8-year period. Twenty-one patients with isolated atlantoaxial subluxation and four with combined atlantoaxial and subaxial disease had their atlantoaxial instability treated by posterior decompression and fusion. The incidence of surgical mortality was 8%, and clinical improvement was noted in 75%. There was no neurological deterioration in those patients who survived long term. We have found posterior decompression and fusion to be a satisfactory procedure for the treatment of atlantooccipital subluxation. In our experience, anterior decompression has not been found necessary for successful treatment of atlantoaxial subluxation in patients with rheumatoid cervical spine disease.
Stanley
D
D
Northern General Hospital, Sheffield, England.
Laing
R J
RJ
Forster
D M
DM
Getty
C J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D002574:Cervical Vertebrae / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D013122:Spinal Diseases / Q000401:mortality / Q000601:surgery / Q000628:therapy; D013123:Spinal Fusion; D016019:Survival Analysis; D016896:Treatment Outcome