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The Journal of Bone and Joint Surgery 78:1911-4 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Compression of the Spinal Cord Due to Destructive Spondyloarthropathy of the Atlanto-Axial Joints. A Case Report*

YOSHIHIRO MIKAWA, M.D.{dagger}, TOSHIO YAMAOKA, M.D.{dagger} and RYO WATANABE, M.D.{dagger}, OKAYAMA, JAPAN

Investigation performed at the Department of Orthopedic Surgery, Kawasaki Medical School, Okayama


   Introduction
 
Destructive spondyloarthropathy was apparently first described by Kuntz et al. in 1984 and has become increasingly recognized in patients who have been managed with long-term hemodialysis. Radiographically evident lesions are located predominantly in the cervical spine. The fifth and sixth and the sixth and seventh cervical intervertebral discs are most frequently involved13. Although destructive spondyloarthropathy affecting the occipitocervical articulation and the cephalad part of the cervical spine has been reported2,5,6,8,12,14, we are not aware of any previous reports of acute compression of the spinal cord attributed to these lesions.

We report the case of a patient who had quadriplegia and dyspnea that were due to destructive spondyloarthropathy of the cephalad part of the cervical spine. Immediate reduction of the atlanto-axial dislocation and posterior arthrodesis of the atlanto-axial joint resulted in remarkable improvement.


   Case Report
 
A forty-five-year-old woman was admitted to our hospital in June 1994 because of progressive quadriplegia and . . . [Full Text of this Article]


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