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Rheumatoid C(1)—C(2) dislocation: pathogenesis and treatment reconsidered

By Chun C. Kao, B. Messert, S. S. Winkler and J. H. Turner


The commonly accepted mechanism of rheumatoid C(1)—C(2) dislocation is the incompetence of the transverse ligament of C(1) vertebra. The presence of rheumatoid granulation tissue between the anterior arch of C(1) vertebra and the odontoid process is an important factor. This might explain why the dislocation becomes irreducible when the disease progresses. In a 55 year old man, transoral removal of the rheumatoid granulation tissue made the previously irreducible C(1)—C(2) dislocation reducible. Stabilization of the reduced C(1)—C(2) articulation was accomplished at a second operation by posterior fusion of the occiput to C(1), C(2), and C(3) vertebrae

Topics: Articles
Year: 1974
DOI identifier: 10.1136/jnnp.37.9.1069
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Provided by: PubMed Central
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