[The case of severe craniocervical dislocation due to rheumatoid arthritis].
The authors describe a case of craniocervical dislocation secondary to rheumatoid arthritis producing important canal narrowing: ventrally by migrated odontoid and dorsally by posterior arch of C-1 with medullary compression. Symptoms of hyperreflexia, spasticity and left hemiparesis with Babinski sign were present.


METHODS
transoral odontoidectomy was performed followed by suboccipital approach, C-1 laminectomy and occipitocervical fixation (Olerud device and bone graft). Outcome with neurologic improvement.


CONCLUSIONS
Transoral odontoidectomy combined with occipitocervical decompression and fixation is effective approach for treatment of severe craniocerebral dislocation. Its advantages: ventral and dorsal decompression combined with immediate stabilisation.
Radek
A
A
Kliniki Neurochirurgii Wojskowej Akademii Medycznej w Lodzi.
Zapałowicz
K
K
Maciejczak
A
A
Skiba
P
P
Olerud
S
S
D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012886:Skull / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology; D014057:Tomography, X-Ray Computed
Przypadek powaznej dyslokacji pogranicza czaszkowo-kregosłupowego na tle reumatoidalnego zapalenia stawów.