Vertical translocation: the enigma of the disappearing atlantodens interval in patients with myelopathy and rheumatoid arthritis. Part I. Clinical, radiological, and neuropathological features.

@article{Casey1997VerticalTT,
  title={Vertical translocation: the enigma of the disappearing atlantodens interval in patients with myelopathy and rheumatoid arthritis. Part I. Clinical, radiological, and neuropathological features.},
  author={Adrian T. H. Casey and H. Alan Crockard and Jennian F. Geddes and John Stevens},
  journal={Journal of neurosurgery},
  year={1997},
  volume={87 6},
  pages={
          856-62
        }
}
This statistical comparison between patients with cervical myelopathy secondary to horizontal atlantoaxial subluxation and those with vertical translocation is designed to elucidate the mechanisms responsible for cranial settling and the effect of translocation on the development of spinal cord compression. In a 10-year study of a cohort of 256 patients, 186 suffered from myelopathy and 116 (62%) of these exhibited vertical translocation according to the Redlund-Johnell criteria. Vertical… 
Vertical translocation. Part II. Outcomes after surgical treatment of rheumatoid cervical myelopathy.
TLDR
Multiple logistic regression models were constructed based on the preliminary evidence of the authors' univariate analysis and these confirmed the importance of preoperative neurological function, spinal cord area, and the degree of vertical translocation in influencing the final neurological grade.
[Transoral decompression of the brain stem in a basilar impression secondary to rheumatoid arthritis. Description of a case and survey of the literature].
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The neurological improvement of a female patient with a long history of rheumatoid arthritis after the decompressive odontoidectomy suggests that the mechanical compression of the odontoids process with impaction of the brain stem was the predominant aetiological factor causing the symptoms in the medulla oblongata.
Cervical laminectomy without fusion in patients with rheumatoid arthritis.
TLDR
It is concluded that decompressive laminectomy in which the facet joints are preserved can be performed in the rheumatoid arthritis-affected cervical spine in selected patients in whom signs of cord compression are demonstrated, but in whom radiographic and preoperative signs of instability are not.
Surgical Outcome in Rheumatoid Ranawat Class IIIb Myelopathy
TLDR
A large subset of patients with CVJ rheumatoid myelopathy may reach Class IIIb, and improvement of even one grade in their Ranawat score from Class IIIB to Class IIIa brought about by surgery confers on them a significant benefit in terms of their quality of life and survival.
Rationale and design of The Delphi Trial – I(RCT)2: international randomized clinical trial of rheumatoid craniocervical treatment, an intervention-prognostic trial comparing 'early' surgery with conservative treatment [ISRCTN65076841]
TLDR
Early surgical atlantoaxial fixation in patients with rheumatoid arthritis and radiological abnormalities without neurological deficits will be compared with prolonged conservative treatment, to identify the best timing of surgery for patients at risk for the development of neurological signs and symptoms.
Surgical treatment outcome on a national cohort of 176 patients with cervical manifestation of rheumatoid arthritis
TLDR
The neurological outcome after fusion surgery is poor and the death rate is high in patients with cervical RA-related instability and deformity, particularly in patients instrumented with laminar hooks.
Superior odontoid migration in the Klippel–Feil patient
TLDR
In patients with KFS, increases in the number of congenitally fused segments and in the degree of coronal cervical alignment were strongly associated risk factors contributing to an increase in SOM.
Morphological and Volumetric Analysis of the Development of Atlantoaxial Vertical Subluxation in Rheumatoid Arthritis
TLDR
3-dimensional analysis revealed that decreases in the volumes at the UCS were associated with VS development, and no significant relationship between OP and the VS development was observed.
Upper Cervical Subluxation and Cervicomedullary Junction Compression in Patients with Rheumatoid Arthritis
TLDR
BI has a very strong possibility of CMJ compression, while AAS and pannus formation have a high proportion in CMJ compressed, and bilateral wrist joint erosion can be used as an indicator for the timing of screening test for cervical involvement.
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TLDR
Between 1978 and 1984, the authors treated 45 rheumatoid arthritis patients who were symptomatic with "cranial settling"; this consisted of vertical odontoid penetration through the foramen magnum, occipito-atlanto-axial dislocation, lateral atlantal mass erosion, and rostral rotation of the posterior arch of C-1 producing ventral and dorsal cervicomedullary junction compromise.
Reduction of rheumatoid periodontoid pannus following posterior occipito-cervical fusion visualised by magnetic resonance imaging.
TLDR
Nine patients with chronic rheumatoid arthritis and atlanto-axial instability subjected to occipito-cervical fusion were evaluated clinically and radiologically and MR findings of a reduction or even disappearance of pannus following posterior fusion should decrease the need for transoral surgery.
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In a prospective survey of 476 hospital in-patients with rheumatoid arthritis, vertical atlanto-axial subluxation (AAL) was found in 13 patients (3.7 per cent). All were women with severe rheumatoid
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TLDR
The clinical and radiographic findings of 194 patients with rheumatoid arthritis and atlantoaxial (C1-C2) subluxation and/or atlantonaxial impaction were reviewed and Settling of the skull and C1 onto C2 (AAI) were considered to be present.
Natural History of Atlanto-Axial Subluxation in Rheumatoid Arthritis
TLDR
This study concluded that the atlanto-axial subluxation is compatible with life, but some patients require surgical intervention.
Atlanto-axial subluxation in rheumatoid arthritis. A 5-year follow-up study.
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TLDR
A curious discrepancy between the amount of subluxation and the presence of neurological damage led to the supposition that this finding could often be relatively innocuous and indicated the need for a follow-up study to clarify the natural history of rheumatoid disease in this region.
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TLDR
It is found that flexion and extension lateral radiographs, combined with sagittal short TR/short TE MR images in the neutral position, enable preoperative evaluation of patients with rheumatoid arthritis in the cervical spine.
Functional Evaluation of the Spinal Cord by Magnetic Resonance Imaging in Patients with Rheumatoid Arthritis and Instability of Upper Cervical Spine
TLDR
Surgical Intervention, either by a posterior approach only or combined with a transoral dens and inflammatory tissue resection, is recommended in patients with progressive atlanto-axial instability, pathologic clinical and neurophysiologic findings, and a spinal cord diameter of less than 6 mm in flexion.
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TLDR
C1-C2 lateral facet joint involvement is common in RA, correlates with disease severity generally and specifically with that in the cervical spine, and, when severe, causes nonreducible rotational tilt of the patient's head.
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TLDR
A classification of the pain and the neural involvement in patients with rheumatoid arthritis and a new method of measuring superior migration are devised and the results show that four of five patients who had an anterior fusion had no improvement and the condition was made worse in two.
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