title: The use of traction methods to correct severe cervical deformity in rheumatoid arthritis patients: a report of five cases.
abstract: METHODS
  A case series is presented.
  
  
  OBJECTIVE
  To describe the methods of correction used in this study for flexible severe cervical deformity, and to report the results in patients with rheumatoid arthritis.
  
  
  BACKGROUND
  Long-standing rheumatoid arthritis can lead to severe cervical deformity, causing significant functional deficits and poor cosmesis. Information on the use of traction combined with surgical stabilization to achieve correction of flexible deformity in rheumatoid patients is sparse in the English literature.
  
  
  METHODS
  A review of five cases, including pertinent history, physical examination, radiographic evaluation, traction techniques, surgical stabilization, and outcomes, was conducted.
  
  
  RESULTS
  Excellent correction of deformity and radiographic union were achieved in all the patients. One patient had minimal loss of correction after surgery and thereafter remained stable. Pin tract infections were the only significant complication.
  
  
  CONCLUSIONS
  Severe cervical flexible deformity in rheumatoid patients can cause significant disability and can be treated successfully with a combination of traction techniques and surgical stabilization.
authors.affiliation: Section of Orthopaedic Surgery, University of Michigan Hospital, Ann Arbor, Michigan 48109, USA. Graziano@umich.edu
authors.forename: G P
authors.initials: GP
authors.lastname: Graziano
authors.forename: R
authors.initials: R
authors.lastname: Hensinger
authors.forename: C K
authors.initials: CK
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D009989:Orthotic Devices; D013122:Spinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D013123:Spinal Fusion; D014057:Tomography, X-Ray Computed; D014143:Traction; D016896:Treatment Outcome