Medknow Publications on behalf of the Neurological Society of India
Vol. 53, No. 2, 2005, pp. 238-240
Bioline Code: ni05075
Full paper language: English
Document type: Research Article
Document available free of charge
Neurology India, Vol. 53, No. 2, 2005, pp. 238-240
© Copyright 2005 Neurology India.
Technical Report - Atlantoaxial joint distraction for treatment of basilar invagination secondary to rheumatoid arthritis|
Goel Atul, Pareikh S., Sharma P.
We present our experience of treating two cases of rheumatoid arthritis involving the craniovertebral junction and having marked basilar invagination by an alternative treatment method. In both the cases, the facets were osteoporotic and were not suitable for screw implantation. The patients were 66 and 72 years of age and both patients were females. Both the patients presented with complaints of progressively increasing spastic quadriparesis. Surgery involved attempts to reduce the basilar invagination and restore the height of the ′collapsed′ lateral mass by manual distraction of the facets of the atlas and axis and forced impaction of titanium spacers in the joint in addition to bone graft harvested from the iliac crest. The procedure also provided stabilization of the region. No other fixation procedure involving wires, screws, plate and rods was carried out simultaneously. Following surgery both the patients showed symptomatic improvement and partial restoration of craniovertebral alignments. Follow-up is of 2 and 24 months. Distraction of the facets of atlas and axis and impaction of metal implant and bone graft in the facet joint can assist in reduction of basilar invagination and fixation of the region in selected cases of rheumatoid arthritis involving the craniovertebral junction.
Basilar invagination, craniovertebral junction, rheumatoid arthritis
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