Romatoid artrite bağlı atlanto-aksiyel instabilite ve cerrahi tedavisi: Olgu sunumu

Romatoid artritin en önemli komplikasyonlarından biri atlanto-aksiyel eklemde yarattığı instabilitedir. Bu durumun miyelopatiye neden olduğu ve bazen ölümcül sonuçlanabildiği bilinmektedir. Bu nedenle, ağır instabilite gösteren olgularda C1-C2 füzyonu gerekmektedir. Bu yazıda, atlanto-aksiyel instabilite ve boyun ağrısı nedeniyle C1-C2 füzyonu uygulanan 58 yaşında kadın hasta sunulmaktadır. Transartiküler vida fikasyonu ve Gallie tekniği ile serklaj şeklinde yapılan stabilizasyon ve füzyon ameliyatı ile tam iyileşme sağlanan olguda ameliyat sonrası ikinci yılda yapılan kontrolde füzyon bölgesinde herhangi bir problemle karşılaşılmadı, nörolojik muayene normal bulundu.

Anahtar Kelimeler:

Artrit, romatoid, Omurilik füzyonu, Omurilik hastalıkları, Çıkıklar, Cerrahi işlemler, operatif, Eklem instabilitesi, Atlanto-aksiyel eklem

Surgical treatment of atlanto-axial instability in rheumatoid arthritis

One of the most important complications of rheumatoid arthritis is atlanto-axial instability. It is well-known that this condition may cause myelopathy and may sometimes be fatal. Therefore, patients with severe instability require C1-C2 fusion. We report a 58-year-old female patient who underwent C1-C2 fusion because of atlanto-axial instability and intractable neck pain. Full recovery and fusion were achieved using atlanto-axial transarticular screw fixation and the Gallie wiring technique. On follow-up examination in the second year, no complications were encountered in the fusion area and neurologic examination was normal.

Keywords:

Arthritis, Rheumatoid, Spinal Fusion, Spinal Diseases, Dislocations, Surgical Procedures, Operative, Joint Instability, Atlanto-Axial Joint,

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