THE ROLE OF PLATE AND SCREW FIXATION IN OCCIPITOCERVICAL FUSION IN RHEUMATOID-ARTHRITIS

被引：77

作者：

GROB, D

DVORAK, J

PANJABI, MM

ANTINNES, JA

机构：

[1] Departments of Orthopaedic Surgery, Spine Unit, Schulthess Klinik, Zurich

[2] Departments of Neurology, Spine Unit, Schulthess Klinik, Zurich

[3] Department of Orthopaedics and Rehabilitation, Yale University, School of Medicine, New Haven, CT

[4] The Pennsylvania State University, School of Medicine, Hershey Medical Center, Hershey, PA

来源：

SPINE | 1994年 / 19卷 / 22期

关键词：

OCCIPITOCERVICAL FUSION; RHEUMATOID ARTHRITIS; PLATE FIXATION;

D O I：

10.1097/00007632-199411001-00009

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design. In a clinical retrospective study, the results of occipitocervical fusion in patients with rheumatoid arthritis were studied and analyzed. Objectives. The results of two different operative techniques were compared. The advantages of screw fixation compared with wiring techniques in this population of patients were investigated. Summary of Background Data. Numerous different implants have been presented in the literature for occipitocervical fusion in patients with rheumatoid arthritis. The use of wires being the standard fixation technique. Methods. Occipitocervical fusion was performed in patients with rheumatoid arthritis: 26 patients with the wiring technique and 33 patients with a new Y-plate fixation. The results were compared at a follow-up period of 24 months and 50 months, respectively. Clinical and radiologic results were investigated. Results. The atlantodental distance could be significantly better reduced in the group with the Y-plate fixation and the neurologic improvement in the wiring group was 40%, whereas in the Y-plate fixation 86% of neurologic improvement was observed. Pseudarthrosis was seen in 27% of the wiring technique and in 6% in the plate and screw fixation technique. Conclusions. In occipitocervical fusion for patients with rheumatoid arthritis, the screw and plate fixation technique provides superior results than other techniques using wire fixations.

引用

页码：2545 / 2551

页数：7

共 44 条

[1]

Boden S.C., Dodge L.D., Bohlmann H.H., Rechtine G., Rheumatoid arthritis of the cervical spine, J Bone Joint Sure, 75-A, pp. 1282-1297, (1993)

[2]

Brattstrom H., Granholm L., Atlanto-axial fusion in rheumatoid arthritis, Acta Orthop Scand, 47, pp. 619-628, (1973)

[3]

Clark C.R., Goetz D.D., Menezes A.H., Arthrodesis of the cervical spine in rheumatoid arthritis, J Bone Joint Surg, 71-A, pp. 381-391, (1989)

[4]

Conaty J.P., Morgans E.S., Cervical fusion in rheumatoid arthritis, J Bone Joint Surg, 63A, pp. 1218-1227, (1981)

[5]

Flint G.A., Hockley A.D., McMillan J.J., Thompson A.G., A new method of occipitocervical fusion using internal fixation, Neurosurgery, 21, pp. 947-950, (1987)

[6]

Foerster O., Die Leitungsbahnen Des Schmerzgefiihls Und Die Chirurgische Behandlung Der Schmerzzustande, (1927)

[7]

Grob D., Magerl F., Operative Stabilisierung bei Frakturen von Cl und C2, Orthopade, 16, pp. 46-54, (1987)

[8]

Grob D., Magerl F., Seemann P., Operative atlanto-axiale Stabilisierung, Neuroorthopadie, pp. 137-140, (1988)

[9]

Grob D., Dvorak J., Gschwend N., Frohlich M., Posterior occipito-cervical fusion in rheumatoid arthritis, Arch Orthop Trauma Surg, 110, pp. 38-44, (1990)

[10]

Grob D., Crisco J., Panjabi M.M., Dvorak J., Biomechanical evaluation of four different posterior atlanto-axial fixation techniques, Spine, 17, pp. 480-490, (1991)

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