Abstract
Since 1991 we have treated 12 patients (three male and nine female) with rheumatoid cervical spines who had neural deficits. Treatment was occipito-cervical fusion (OCF) using a titanium instrument (TI-loop) . Average age at the time of operation was 57 years. Indication for OCF was an irreducible anterior atlanto-axial subluxation (AAS) or vertical subluxation (VS) . Laminectomy of C1 was performed in all cases, and double-door laminoplasty was added in six cases with spinal stenosis. Ranawat's classification was used to evaluate neural deficits and pain. Postoperative follow-up was 2 to 44 months, with an average of 21 months. Pain control results and radiological findings were excellent, but there were limitations in neurological recovery, especially in those cases with severe deficits such as those of the scale of Ranawat IIIB. No breakage of the TI-loop was found. The TI-loop was found to be very useful as a biocompatible and MRI-compatible biomaterial instrument.
