Atlanto-axial subluxation occurs with a frequency varying from 6% to 45% in rheumatoid arthritis. Most patients are treated conservatively with a cervical collar. The effectiveness of different cervical collars in inhibiting anterior atlanto-axial subluxation was tested in 11 patients with classical rheumatoid arthritis. None of the collars had any major influence in inhibiting anterior subluxation of the atlas in maximal flexion. Furthermore, the harder collars with a stable cervical stand forced the atlas to subluxate anteriorly in some of the patients.
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