Surgical Treatment of the Cervical Spine in the Rheumatoid Arthritis Patient

The results of surgical treatment performed on the cervical spine of 12 patients with rheumatoid arthritis were evaluated.The mean age at the time of operation was 56.4 years (range; 44-63 years) and the mean duration of the disease was 18 years (range; 5-38). They were followed-up for a mean of 3 years 5 months (range; 4 months-6 years 6 months). llpatients achieved relief of their occipitocervical pain, and paralysis improved in seven.In two patients with atlanto-axial subluxation (AAS) and vertical subluxation (VS), cranio-cervical stabilization was performed producing good. Anterior fusion was performed in five patients with subaxial subluxation (SS), but graft compression or subluxation above or below the fused segments occurred in four patients, and two patients required further surgery. Cranio-cervical stabilization for SS, AAS, VS was performed in five patients and the results obtained were good.We regard cranio-cervical stabilization using instrumentation as useful in the treat ment of cervical spinal problems in Rheumatoid Arthritis patients.