title: Cervical myelopathy due to atraumatic odontoid fracture in patients with rheumatoid arthritis: A case series.
abstract: To highlight the risk of cervical myelopathy due to occult, atraumatic odontoid fracture in patients with rheumatoid arthritis, we retrospectively reviewed radiographic findings and clinical observations for 7 patients with this disorder. This fracture tends to occur in patients with long-lasting rheumatoid arthritis and to be misdiagnosed as simple atlantoaxial dislocation. Since this fracture causes multidirectional instability between C1 and C2 and is expected to have poor healing potential due to bone erosion and inadequate blood supply, posterior spinal arthrodesis surgery is indicated upon identification of the fracture to prevent myelopathy.
authors.affiliation: a Department of Orthopedic Surgery , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takahata
authors.affiliation: a Department of Orthopedic Surgery , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Abumi
authors.affiliation: a Department of Orthopedic Surgery , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Sudo
authors.affiliation: a Department of Orthopedic Surgery , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Nagahama
authors.affiliation: a Department of Orthopedic Surgery , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Norimasa
authors.initials: N
authors.lastname: Iwasaki
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001268:Atlanto-Axial Joint / Q000473:pathology / Q000503:physiopathology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000209:etiology / Q000517:prevention & control; D013123:Spinal Fusion / Q000379:methods*
keywords: Atlantoaxial instability; Atraumatic occult fracture; Myelopathy; Odontoid fracture; Rheumatoid arthritis