Fusion ofthe occiput to the upper cervical spine is an uncommon but important operation as it is the only means ofpermanently stabilising the interveningjoints. Instability ofthe atlas or axis on the remainder of the cervical spine is dangerous, and if it progresses to subluxation or dislocation there is a risk of damage to the medulla, spinal cord and nerve roots. Fusion may be required for pr...

Fifteen patients with classic rheumatoid arthritis were investigated with plain films, pluridirectional tomography, and surface-coil T1-weighted MR imaging at 500/17 (TR/TE). We evaluated the atlantodental interval; basion-dental interval; density or intensity of the dens; dens erosion; cranial settling; anterior, posterior, lateral, or rotatory atlantoaxial subluxation; subaxial subluxation; l...

The synovitis of rheumatoid arthritis (RA) injures structures in the cervical spine, allowing atlantoaxial subluxation, atlantoaxial impaction, and subaxial subluxation. Spinal cord and vertebral artery injury can ensue. Subluxations are common, but neurologic abnormalities are less so. Patients with RA can die from subluxations but usually do not, although many become worse with time. Nonsurgi...

Twenty-six patients with rheumatoid disease affecting the cervical spine underwent surgical treatment for neck pain, neurological deficit, or both. Atlantoaxial subluxation (n=13), subaxial subluxation (n=7) and vertical migration of the odontoid (n=6) were treated. Arthrodesis with autologous bone was augmented with wire, Ransford loop, Hartshill rectangle or Magerl technique. Pain relief occu...

INTRODUCTION Although uncommon, fractures of the os odontoideum are known to occur in children under 7 years old, following acute trauma. CLINICAL PICTURE We report a case of chronic subluxation of the os odontoideum resulting in cervical myelopathy in a child with Beare-Stevenson cutis gyrata syndrome after surgery to the head and neck. TREATMENT AND OUTCOME The patient was initially put i...

The work described here was prompted by our interest in the pathogenesis of spontaneous cervical subluxation in rheumatoid arthritis. Anatomical studies of rheumatoid cervical spines (Ball, 1958) had revealed destructive inflammatory lesions in the disks and posterior spinal joints, but not in the ligamenta flava; segmental ankylosis, erosion of certain ligamentous attachments, and disk degener...

Cervical facet fractures and dislocations represent approximately 6% of all cervical spine fractures.1 The clinical spectrum of these injuries ranges from patient being neurologically intact to complete neurological deficits. They can be unilateral or bilateral and may be associated with subluxation or dislocations. The unilateral facet dislocations are produced because of flexion, hyperextensi...

BACKGROUND Cervical spine injuries are the most commonly missed severe injuries with serious implications for the patient and physician. The diagnosis of subluxations or spinal cord injuries in the absence of vertebral fractures, especially in unevaluable patients, poses a major challenge. The objective of this study was to study the incidence and type of cervical spine trauma according to mech...

BACKGROUND There is no consensus on the role of preoperative cervical spine radiographs to screen for instability in patients with rheumatoid arthritis (RA). OBJECTIVES This study aimed to evaluate the preoperative use of cervical spine radiographs in patients with RA undergoing preoperative anesthesia assessment and to determine whether preoperative radiographic findings influenced anesthesi...