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MR Vol.14 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.14 No.2 |
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Management of cervical spinal lesions in rheumatoid
arthritis |
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| Kazuo Yonenobu1 and Takenori Oda2 |
(1) Department of Orthopaedic Surgery, Osaka-Minami
Medical Center, 2-1 Kidohigashi, Kawachinagano, Osaka, 586-8521,
Japan
(2) Department of Rheumatology and Orthopaedics, Osaka-Minami Medical Center,
Osaka, Japan |
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| Abstract |
| We review the management of cervical spinal
lesions in rheumatoid arthritis. Surgical treatment for cervical
lesions
presents several potential problems, such as spinal cord injury during
surgery, prolonged and painful postoperative immobilization, poor
outcome incompatible with surgical invasiveness, and a high failure
rate of arthrodesis. The introduction of spinal instrumentation techniques
to surgery for cervical lesions has solved some of these problems.
Rigid spinal fixation using screws, rods, and wires has made surgery
more reliable, and has freed patients from painful postoperative
immobilization methods such as the Halo vest. However, the effects
of surgical treatment have not been clearly examined using methods
of evidence-based medicine. There is a need for clinical studies
of treatment for cervical lesions, in order to help establish better
methods for the management of cervical spinal lesions. |
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| Key words |
| Atlantoaxial subluxation (AAS) - Natural history
- Rheumatoid arthritis (RA) - Subaxial subluxation (SS) - Vertical
subluxation (VS) of the axis |
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