Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashi, Kawachinagano, Osaka, 586-8521, Japan.
Mod Rheumatol. 2012 Aug;22(4):605-9. doi: 10.1007/s10165-011-0547-z. Epub 2011 Oct 18.
We report an uncommon case of positional occlusion of the vertebral artery associated with rheumatoid arthritis (RA). Plain radiography showed reducible atlantoaxial subluxation, and dynamic vertebral arteriography demonstrated positional occlusion of the left vertebral artery. The patient was treated with C1-2 posterior fusion and has since experienced no recurrent symptoms. Insufficiency of the vertebrobasilar artery is a relatively uncommon complication with cervical lesions in RA patients. However, when RA patients manifest recurrent cerebral and cerebellar symptoms, this condition should be kept in mind and actions taken to avoid further irreversible cerebral damage. Recommended imaging methods include vertebral dynamic lateral plain radiography of the cervical spine and vertebral arteriography at multiple cervical positions.
我们报告了一例与类风湿关节炎（RA）相关的椎动脉位置性闭塞的罕见病例。平片显示寰枢关节可复性半脱位，动态椎动脉造影显示左侧椎动脉位置性闭塞。患者接受了 C1-2 后路融合术，此后未再出现复发症状。椎动脉基底动脉不足是 RA 患者颈椎病变的一种相对少见的并发症。然而，当 RA 患者出现反复的大脑和小脑症状时，应牢记这种情况，并采取措施避免进一步的不可逆转的脑损伤。推荐的影像学方法包括颈椎的椎动脉动态侧位平片和多个颈椎位置的椎动脉造影。
