Zygmunt S, Säveland H, Brattström H, Ljunggren B, Larsson E M, Wollheim F
Department of Neurosurgery, University Hospital, Lund, Sweden.
Br J Neurosurg. 1988;2(3):315-20. doi: 10.3109/02688698809001001.
Nine patients (four females and five males) with chronic rheumatoid arthritis (RA) and atlanto-axial (AA) instability subjected to occipito-cervical fusion were evaluated clinically and radiologically. All of them had soft tissue formation (pannus) around the odontoid peg. The age ranged from 50 to 79 years (mean: 66). The duration of the RA disease was 3-48 years (mean: 18.5). All patients were seropositive. Both conventional radiography and magnetic resonance imaging (MR) were performed pre- and postoperatively. All fusions except one were stable. One patient was re-fused after 2 months because of wire break. With regard to pain all patients had improved and eight were pain free. Six patients who experienced signs of myelopathy prior to the fusion had improved at follow up. MR revealed reduction of pannus in all nine cases. This was obvious in one patient within 6 weeks postoperatively. The MR findings of a reduction or even disappearance of pannus following posterior fusion should decrease the need for transoral surgery.
对9例患有慢性类风湿性关节炎（RA）且伴有寰枢椎（AA）不稳并接受枕颈融合术的患者（4名女性和5名男性）进行了临床和影像学评估。他们所有人的齿突周围均有软组织形成（血管翳）。年龄范围为50至79岁（平均：66岁）。RA病程为3至48年（平均：18.5年）。所有患者血清学均呈阳性。术前和术后均进行了传统X线摄影和磁共振成像（MR）检查。除1例之外，所有融合均稳定。1例患者因钢丝断裂在2个月后再次进行融合。关于疼痛，所有患者均有改善，8例无痛。6例在融合术前出现脊髓病体征的患者在随访时有所改善。MR显示所有9例患者的血管翳均减少。这在1例患者术后6周内很明显。后路融合术后血管翳减少甚至消失的MR表现应会减少经口手术的需求。
