S. Zygmunt et al., OCCIPITOCERVICAL (BRATTSTROM-GRANHOLM) FUSION FOR RHEUMATOID ATLANTOAXIAL SUBLUXATION - A LONG-TERM FOLLOW-UP OF 147 PATIENTS, Aktuelle Rheumatologie, 19(6), 1994, pp. 186-190
147 patients with rheumatoid arthritis (RA) and atlanto-axial subluxat
ion operated on with posterior occipito-cervical (Brattstram-Granholm)
fusion over an 18 year period (November 1970-November 1988) were foll
owed. 112 were female, 35 were men. The mean age at operation was 62 y
ears. Before surgery, the major symptoms were occipital headache, neck
pain and/or myelopathy. The mean follow-up time was 55 months. Clinic
al improvement was obtained in 87 % of the patients, 8 % were unchange
d and 5 % had progressive symptoms in spite of surgery. There was no p
eroperative or immediate postoperative mortality. 18 reoperations were
performed in the neck and 2 at the donor site for the bone transplant
. The result offers further evidence for the beneficial effect of post
erior occipito-cervical fusion in patients with rheumatoid atlanto-axi
al subluxations. We conclude that posterior fusion with the Brattstrom
-Granholm technique is a safe and effective method for restabilization
of the unstable rheumatoid neck.