Clinical Neuroscience

[Operative treatment of craniocervical instabilities caused by rheumatoid arthritis]

TURÓCZY László1, KENÉZ József2, VERES Róbert1, NAGY Aladár1, PÁSZTOR Emil3

JANUARY 20, 1993

Clinical Neuroscience - 1993;46(01-02)

[We have investigated and operatively treated 30 patients with craniocervical instabilities caused by rheumatoid arthritis. The evaluation of this patient-material seems to be important, because the indications of operations in the different stages of the disease are not completely clear, according to our knowledge. The atlanto-axial instabilities at the beginning stage, when the serious neurologic signs are absent, can be treated with low risk dorsal stabilization, while we believe the advanced instabilities need combined neurosurgical approach for successful treatment. We must emphasize the importance of detailed early diagnostics, and the prevention in neurosurgical approaches, in accordance of the opinions, expressed in different contributions in the literature, dealing with the subject. In 20 cases we had to perform combined surgical interventions, and only in 10 cases, the simple dorsal fixation proved to be satisfactory, which fact shows, that we got patients mainly in more serious stages. We detected a new sign ("ghost tumor") in the natural course of the disease.]

AFFILIATIONS

  1. Országos Traumatológiai Intézet, Idegsebészet, Budapest
  2. SOTE Neurológiai Klinika, Budapest
  3. Országos Idegsebészeti Tudományos Intézet, Budapest

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