Document Detail


Management of recalcitrant osteoarthritis of the atlanto-axial joint.
MedLine Citation:
PMID:  16866096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The medical records and radiographs of 17 patients with recalcitrant pain secondary to C1-C2 osteoarthritis were independently reviewed. All patients were treated by the senior author (K.D.R.). Initial treatment included physical therapy, nonsteroidal anti-inflammatory drugs, and soft collar immobilization. If non-responsive, patients were referred to a single radiologist for injection of the involved C1-C2 joint(s). If symptoms persisted, then transarticular screw fixation and Magerl wire fixation with structural iliac crest bone graft was performed. Postoperatively, all patients were placed in a soft collar. Postoperative anteroposterior (AP), lateral, flexion/extension, and open-mouthed odontoid radiographs were taken at 6 weeks, 3 months, and 1 year. Three independent observers assessed all radiographs for fusion. Fusion was noted by radiographic evidence of bridging bony trabeculae across the C1-C2 joint and/or bridging bone from the posterior arch of C1 to the C2 spinous process. Patient satisfaction improved significantly whether they were treated by corticosteroid injection or surgically.
Authors:
Timothy R Kuklo; K Daniel Riew; Joseph R Orchowski; Douglas S Won; Teresa M Schroeder; Louis A Gilula
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  29     ISSN:  0147-7447     ISO Abbreviation:  Orthopedics     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-26     Completed Date:  2006-11-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633-8     Citation Subset:  IM    
Affiliation:
Walter Reed Army Medical Center, Dept of Orthopedic Surgery and Rehabilitation, 6900 Georgia Ave, NW Washington, DC 20307-5001, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use*
Aged
Aged, 80 and over
Atlanto-Axial Joint / drug effects,  surgery*
Female
Humans
Male
Neck Pain / drug therapy,  etiology,  surgery*
Osteoarthritis / complications,  drug therapy,  surgery*
Patient Satisfaction
Retrospective Studies
Spinal Fusion / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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