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Positional occlusion of the vertebral artery in a case of rheumatoid atlantoaxial subluxation presenting with multiple cerebral and cerebellar infarction.
Mod Rheumatol
August 2012
Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashi, Kawachinagano, Osaka, 586-8521, Japan.
We report an uncommon case of positional occlusion of the vertebral artery associated with rheumatoid arthritis (RA). Plain radiography showed reducible atlantoaxial subluxation, and dynamic vertebral arteriography demonstrated positional occlusion of the left vertebral artery. The patient was treated with C1-2 posterior fusion and has since experienced no recurrent symptoms.
View Article and Find Full Text PDFRheumatoid atlantoaxial subluxation can be prevented by intensive use of traditional disease modifying antirheumatic drugs.
J Rheumatol
February 2009
Rheumatism Foundation Hospital, 18120 Heinola, Finland.
Objective: To evaluate the 5-year incidence of cervical spine disorders in patients with early rheumatoid arthritis (RA) treated by 2 different disease modifying antirheumatic drug (DMARD) strategies.
Methods: In a national, multicenter, prospective FIN-RACo-trial, a cohort of 199 patients with early, clinically active RA was randomly assigned to treatment with a combination of 3 DMARD and prednisolone (Combi group) or with a single DMARD (Single group) with or without prednisolone, aiming to induce remission. After 2 years, the DMARD therapy was unrestricted.
Safety of atlantoaxial fusion using laminar and transarticular screws combined with an atlas hook in a patient with unilateral vertebral artery occlusion (case report).
Arch Orthop Trauma Surg
January 2009
Science of Functional Recovery and Reconstruction, Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama city, Japan.
Objective And Importance: A disadvantage of transarticular and C2 pedicle screws is vertebral artery (VA) injury as a result of screw misplacement. If unilateral occlusion of the VA is present, VA injury of the dominant side will cause fatal complications as a result of collateral flow insufficiency. Several authors have recently reported the usefulness of C2 laminar screws because of their safety on VA injury.
View Article and Find Full Text PDFResults after 24 years of prophylactic surgery for rheumatoid atlantoaxial subluxation.
J Bone Joint Surg Br
July 2005
Sapporo Gorinbashi Orthopaedic Hospital in Gorinbashi Health Care Facilities and Hospitals, 2-1 Kawazoe, Minami-ku, Sapporo, Hokkaido 005-0802, Japan. nobuyuki.tanakaryumachi-jp.com
We evaluated the use of surgical stabilisation for atlantoaxial subluxation after a follow-up of 24 years in 50 rheumatoid patients who had some degree of pain but no major neurological deficit. The mortality of patients treated by atlantoaxial fusion was significantly lower than for those who received conservative treatment. The deaths resulted from infection or comorbid conditions.
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