Abstract
We examined the long-term outcomes and limitations of occipito-atlantoaxial fusion for cervical lesions of rheumatoid arthritis (RA) . This study involved 10 patients (2 males and 8 females) who underwent the modified Brattstrom method from 1978 to 1992. The mean RA prevalence period was 15.4 years (8-33 years), the mean age at operation was 61.3 years, and the mean follow-up period was 51 months.
Seven of the 10 cases died an average of 3.3 years after the operation. In all cases the fusion operation was successful and there was almost no failure of correction. However, activity of daily living and neural symptoms deteriorated over a long term. The deterioration was thought to be due to the exacerbation of articular symptoms and to the progression of subluxation of the spine below the fusion in mutilans type RA. These findings should be investigated further with a larger population.
