Özet:

Study Design: 50 rheumatoid patients requiring cervical spine surgery for irıstabilities were retrospectively reviewed. Objectives: A retrospective revievj of our patient population and surgical outcome to determine if utilizing Standard wiring procedures are comparable to previously published reports. Summary of Background Data: Cervical spine instability has been shown to occur early in the course of rheumatoid disease (6, 45, 46, 48, 49). The instability produced, combined with proliferation of synovitic tissue (pan-nus), may compress the spinal cord, nerve roots, and vertebral arteries resulting in pain and neurological abnor-malities. Primary treatment in rheumatoid arthritis of the spine is directed towards prevention of neural compro-mise and for this reason surgical arthrodesis is advised when instability is present. Results: 27 patients had sufficient documentation for inclusion. Some had newer methods of fixation includ-ing plates and screws. Mean follow-up vvas 28 months. Our series demonstrated similar outcome for wiring procedures with 81% bony fusion rate and no neurological deterioration. 11% developed subaxial instability following upper cervical spine procedures. Conclusions: Newer methods of fixation were helpful in treating more complicated cases including multilevel involvements, deformity and higher grade instability.

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