open access

Vol 47, No 3 (2013)
OPIS PRZYPADKU
Submitted: 2012-09-17
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Rheumatoid atlantoaxial instability treated by anterior transarticular C1-C2 fixation. Case report

Krzysztof Zapałowicz, Maciej Radek
DOI: 10.5114/ninp.2013.35487
·
Neurol Neurochir Pol 2013;47(3):290-295.

open access

Vol 47, No 3 (2013)
OPIS PRZYPADKU
Submitted: 2012-09-17

Abstract

Abstract

The authors present a case that demonstrates the usefulness of anterior transarticular screw fixation in the treatment of instability due to rheumatoid arthritis. The surgical technique of this infrequently used procedure is presented. A 35-year-old female patient with medical history significant for rheumatoid arthritis complained of persistent headache and upper neck pain. Examination revealed a decreased range of cervical rotational motion. Magnetic resonance imaging of the cervical spine revealed anterior displacement of C1, destruction of the left lateral atlantoaxial articulation and bony erosion of the C2 vertebral body below the base of the odontoid. Dynamic radiographs showed increased C1-C2 mobility. The authors used a right anterolateral approach to the cervical spine to perform fixation of lateral atlantoaxial articulations by means of titanium cannulated compressive screws. On 4-month follow-up examination, successful C1-C2 stabilization was documented. Despite restriction of neck rotation, the patient reported satisfactory improvement and returned to work.

Abstract

Abstract

The authors present a case that demonstrates the usefulness of anterior transarticular screw fixation in the treatment of instability due to rheumatoid arthritis. The surgical technique of this infrequently used procedure is presented. A 35-year-old female patient with medical history significant for rheumatoid arthritis complained of persistent headache and upper neck pain. Examination revealed a decreased range of cervical rotational motion. Magnetic resonance imaging of the cervical spine revealed anterior displacement of C1, destruction of the left lateral atlantoaxial articulation and bony erosion of the C2 vertebral body below the base of the odontoid. Dynamic radiographs showed increased C1-C2 mobility. The authors used a right anterolateral approach to the cervical spine to perform fixation of lateral atlantoaxial articulations by means of titanium cannulated compressive screws. On 4-month follow-up examination, successful C1-C2 stabilization was documented. Despite restriction of neck rotation, the patient reported satisfactory improvement and returned to work.

Get Citation

Keywords

atlantoaxial instability, cervical spine, spinal fusion, transarticular screws, rheumatoid arthritis

About this article
Title

Rheumatoid atlantoaxial instability treated by anterior transarticular C1-C2 fixation. Case report

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 47, No 3 (2013)

Pages

290-295

DOI

10.5114/ninp.2013.35487

Bibliographic record

Neurol Neurochir Pol 2013;47(3):290-295.

Keywords

atlantoaxial instability
cervical spine
spinal fusion
transarticular screws
rheumatoid arthritis

Authors

Krzysztof Zapałowicz
Maciej Radek

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