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The Journal of Bone and Joint Surgery (American) 85:711-714 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Case Report

Atlantoaxial Arthrodesis for Vertebrobasilar Insufficiency Due to Rheumatoid Arthritis

A Case Report

Toru Maekawa, MD, Kunihiko Sasai, MD, PhD, Hirokazu Iida, MD, PhD, Keiji Yamashita, MD, PhD and Minoru Sakaida, MD, PhD

Investigation performed at the Department of Orthopedic Surgery, Shiga Social Insurance Hospital, Ostu City, Shiga, Japan

Toru Maekawa, MD
Department of Orthopedic Surgery, Kishiwada City Hospital, 1001 Gukuhara-cho, Kishiwada City, Osaka 596-8501, Japan. E-mail address: joayu@nyc.odn.ne.jp

Kunihiko Sasai, MD, PhD
Hirokazu Iida, MD, PhD
Department of Orthopedic Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguti City, Osaka 570-0074, Japan

Keiji Yamashita, MD, PhD
Minoru Sakaida, MD, PhD
Departments of Radiology (K.Y.) and Orthopedic Surgery (M.S.), Shiga Social Insurance Hospital, 16-1 Fujimidai, Otsu City, Shiga 520-0846, Japan

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The first 150 words of the full text of this article appear below.


   Introduction
 
Patients with rheumatoid arthritis often have involvement of the cervical spine, which may lead not only to impairment of activities of daily living but also to sudden death 1 . Cervical instability secondary to rheumatoid arthritis is associated with compression myelopathy in many patients and with vertebrobasilar insufficiency in some patients.

To our knowledge, this is the first report of the surgical treatment of vertebrobasilar insufficiency in a patient with rheumatoid atlantoaxial subluxation without evidence of a compression myelopathy. The subject of this case report was informed that data concerning the case would be submitted for publication.


   Case Report
 
A woman was diagnosed with rheumatoid arthritis in 1982, at the age of forty-five years, and hemodialysis was begun in 1997 to treat chronic renal insufficiency. She was hospitalized repeatedly since 1998 because of difficulty walking due to arthritis of both hips and knees and, in 1998, she underwent a right total . . . [Full Text of this Article]


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