[Posterior atlantoaxial facet screw fixation in rheumatoid arthritis].
OBJECTIVE
To clarify the characteristics of the clinicopathological factors in cases of atlantoaxial instability due to rheumatoid and to introduce a new method for the treatment of this disease.


METHODS
Fifteen patients with atlantoaxial instability due to rheumatoid were treated with posterior facet screws to obtain immediate rigid fixation of C(1 - 2). In this series of patients, screw fixation was augmented with an interspinous C(1 - 2) strut graft which was wired in place to provide three-point stabilization and to facilitate bone fusion.


RESULTS
In each patient fixation was satisfactory, and C(1 - 2) alignment and stability were restored without complication due to instrumentation. All patients showed osseous union (a mean follow-up period of 10 months; range 6 - 14 months).


CONCLUSIONS
Posterior atlantoaxial facet screw fixation provides immediate three-dimension rigid fixation of C(1 - 2) that is biomechanically superior to wiring or other fixation.
Liu
H
H
Arthritis Clinic and Research Center, People's Hospital, Beijing University, Beijing 100044, China.
Lü
H
H
Wei
W
W
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001268:Atlanto-Axial Joint / Q000601:surgery*; D001863:Bone Screws; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000379:methods*