Abstract
Radiographic studies of the lower cervical spine in rheumatoid arthritis (RA) were performed to investigate the influence of the fusion of the upper cervical spine upon the lower. Twenty of 54 patients treated operatively were examined. Fourteen cases with atlanto-axial anterior subluxation were treated with McGraw's procedure and 6 cases with atlanto-axial vertical subluxation were treated with occipito-atlanto-axial fusion. Normal subjects of control were 50 patients who were diagnosed as classical RA and treated conservatively.In each case, narrowing of intervertebral space without osteophyte, end-plate erosion, facet erosion, collapse of vertebral body and anterior subluxation were investigated from four roentgenograms (anteroposterior, lateral including neutral, flexion and extension). Collapse and anterior subluxation were more frequently by seen in cases of occipito-atlanto-axial fusion than in cases of McGraw's procedure and non-operative treatment. This result suggests that the fixation of occipitoatloid joint adds great force to the lower cervical spine.
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