Abstract
ObjectiveA morphological analysis of the bone structure of C2 in patients with rheumatoid arthritis in order to enhance the security of the stabilization procedures for this vertebra.MethodsWe retrospectively analyzed 20 CT scans of the cervical spine performed in patients with rheumatoid arthritis; the following parameters were measured: spinolaminar angle, thickness and length of C2 lamina.ResultsThe mean values are: 5.92mm and 5.87mm for thickness of right and left laminae retrospectively, 27.75mm for right lamina length and 27.94mm for left lamina length, and 44.7º for spinolaminar angle.ConclusionThe values obtained are consistent with studies in normal subjects published by other groups, with no apparent need for change in the screw placement technique. Level of Evidence IV, Case Series.
Highlights
Of the 20 tomography scans included in the study, 17 belonged to female patients and three to male patients
In the current literature we found various studies that use imaging methods to characterize the degenerations of the atlanto-axial joint of patients with rheumatoid arthritis.[1,2,3,11,12]
In the non-statistical comparison, with the results found in healthy individuals for the same parameters, published in a previous study by our group,[10] we realized that the values obtained are equivalent, suggesting that in spite of the multiple joint alterations that develop with the pathology, there is no significant alteration of the morphology of the C2 vertebra
Summary
Tomographic analysis for C2 screw placement in rheumatoid arthritis patients. The indications for arthrodesis are: pain, instability and neurological deficit.[4] Various techniques are used for stabilization of the upper cervical spine with laminar screws.[5,6,7] Previous anatomical and[8,9] tomographic studies[10] evaluated the bone morphology of C2 in normal individuals with the objective of optimizing the safety of these methods.
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