Clinical Results and Problems of Posterior Cervical Decompression and Fixation for Patients with Rheumatoid Arthritis

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Objective : We studied postoperative results and limitations of posterior decompression and fixation for rheumatoid arthritis (RA) superior cervical vertebral lesions.<BR>Subjects and Methods : Subjects were 18 patients with RA - 2 men and 16 women- with a mean age of 60.7 years at surgery. Mean postoperative follow-up was 5 years and 10 months. The disease type was evaluated as arthritis mutilans (MUD) in 12 patients and multi-articular destructive type (MES) in 6. In fixation, occipital bone to superior cervical vertebral fixation was done in 14 and C1-C2 fixation in 4.<BR>Results : According to Renawat's pain grade scaling, improvement was achieved in 5 of 6 in the MES group and in 9 of 12 in the MUD group. The neural deficit class improved in 4 of 6 in the MES group and in 2 of 12 in the MUD group. In 8 of 11 without subaxial subluxation (SAS) before surgery, SAS occurred after surgery. Few patients experienced exacerbated symptoms.<BR>Conclusion : In the MES group, postoperative results were good. In the MUD group, improvement of neural deficit was poor. After surgery, SAS was frequent, 50 techniques must be selected carefully.
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