Stanley D, Laing R J, Forster D M, Getty C J
Northern General Hospital, Sheffield, England.
J Spinal Disord. 1994 Oct;7(5):439-43.
Forty-seven patients with rheumatoid disease of the cervical spine were followed over an 8-year period. Twenty-one patients with isolated atlantoaxial subluxation and four with combined atlantoaxial and subaxial disease had their atlantoaxial instability treated by posterior decompression and fusion. The incidence of surgical mortality was 8%, and clinical improvement was noted in 75%. There was no neurological deterioration in those patients who survived long term. We have found posterior decompression and fusion to be a satisfactory procedure for the treatment of atlantooccipital subluxation. In our experience, anterior decompression has not been found necessary for successful treatment of atlantoaxial subluxation in patients with rheumatoid cervical spine disease.
47例颈椎类风湿病患者接受了为期8年的随访。21例单纯寰枢椎半脱位患者和4例合并寰枢椎及下颈椎疾病的患者，其寰枢椎不稳通过后路减压融合术进行治疗。手术死亡率为8%，75%的患者有临床改善。长期存活的患者无神经功能恶化。我们发现后路减压融合术是治疗寰枕半脱位的一种令人满意的术式。根据我们的经验，对于类风湿性颈椎疾病患者的寰枢椎半脱位，成功治疗并不需要前路减压。
