Concise reports
Successful conservative treatment of rheumatoid subaxial
subluxation resulting in improvement of myelopathy, reduction of
subluxation, and stabilisation of the cervical spine. A report of two
cases
a Departments of
Rheumatology, b Neurology, c and Neurosurgery, d Rheumatology
Twente, Medisch Spectrum Twente, Enschede, the Netherlands
Correspondence to: Dr J C M Oostveen, Rheumatology Twente, Medisch Spectrum Twente, Postbus 50.000, 7500KA Enschede, the Netherlands.
Accepted for publication 2 November 1998
OBJECTIVE
To report
the efficacy of conservative treatment with cervical traction and
immobilisation with a Halo vest, in two consecutive rheumatoid
arthritis patients with progressive cervical myelopathy caused by
subaxial subluxation.
METHODSDescription of
neurological symptoms and signs and findings in plain radiography (PR)
and magnetic resonance imaging (MRI) of the cervical spine before and
after treatment of the subaxial subluxation by traction and
immobilisation with a Halo vest during four months.
RESULTSDuring four
months of traction and immobilisation neurological examination showed a
considerable improvement of the signs and symptoms of cervical
myelopathy. Afterwards PR and MRI of the cervical spine showed
reduction of the subaxial subluxation. Eventually firm stabilisation
was obtained in both patients without surgery of the cervical spine.
CONCLUSIONCervical
traction and immobilisation with a Halo vest can be considered as an
independent conservative treatment in rheumatoid arthritis patients
with cervical myelopathy caused by subaxial subluxation.
© 1999 by Annals of the Rheumatic Diseases
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