RESUMEN
Between 1977 and 1988 twenty-five patients with rheumatoid arthritis involving the cervical spine were treated by an occipito-cervical fusion. Twenty-two patients are included in this study. The main indications for surgery were intractable pain and progressive neural impairment. The operative procedure consisted of an H-bone graft fixed with steel wire in 19 cases, fusion of occiput-C2 six times and of occiput-C3 thirteen times. A Hartshill-Ransford (5, 12) loop was used in three cases: occiput-C3 twice and occiput-C7 once. The mean duration of follow-up was 3 years 8 months in 17 patients. Improvement of symptoms and signs was achieved in 88%. There were 2 post-operative deaths. The high rate of pseudarthrosis in our series was confirmed by several authors. The loop technique provides a more stable fixation and will be our technique of choice in the future.
Asunto(s)
Artritis Reumatoide/cirugía , Articulación Atlantooccipital/cirugía , Fusión Vertebral/métodos , Adulto , Anciano , Articulación Atlantooccipital/diagnóstico por imagen , Hilos Ortopédicos , Vértebras Cervicales/cirugía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
A case of pigmented villonodular synovitis of the hip is presented. The delay between the onset of symptoms and the histopathologic confirmation of this condition generally accounts for the massive local bone invasion, frequently necessitating a total hip arthroplasty. Earlier diagnosis through arthroscopy and subsequent chemical synoviorthesis might reduce the need for more aggressive surgery and improve the prognosis of this rare condition.