ACTIVE CONSERVATIVE TREATMENT OF ATLANTOAXIAL SUBLUXATION IN RHEUMATOID-ARTHRITIS

Twenty patients with rheumatoid atlantoaxial subluxation (AAS) underwe nt an active conservative treatment programme, aiming at relieving the symptoms and influencing the natural course of AAS. The treatment con sisted of intensive multiprofessional intervention in the hospital for a fortnight, and control and motivational visits 6 and 12 months late r. The patients self-evaluated the symptoms several times, and the cer vical spine radiographs were taken at the first and last visit. Sevent een of the 20 patients adopted the instructions well and undertook the exercise programme at least weekly, even after a 12 month follow-up. Cervical pain was significantly reduced (P < 0.001) during the first i ntervention, and the favourable effect continued at least 12 months. P romising changes were also seen in some cervical radiographs. It is po ssible to educate and motivate AAS patients to take active care of the ir neck, and to relieve their chronic neck pain significantly. Atlanto axial instability may also be reduced during active conservative treat ment.