Q J Med 1981; 50: 307-319
© 1981 Association of Physicians
research-article |
Rheumatoid Cervical Myelopathy
From the Withington Hospital Manchester
Accepted for publication 6 March 1981.
The mode of presentation and the factors which influenced the diagnosis and outcome in 31 patients with rheumatoid cervical myelopathy were reviewed. The presenting features included paraesthesiae and/or numbness (23 cases) weakness (six) flexor spasms (five) and incontinence (two). Isolated sensory loss presenting in a glove and stocking distribution was often misdiagnosed as a peripheral neuropathy. Multiple neurological deficits were eventually present in all patients and included spastic quadriparesis (17), spastic paraparesis (seven), bladder disturbance (nine), and cranial nerve deficits (six). Twenty-seven patients had impaired light touch and pin prick sensation but the sensory level did not correlate with the presumed level of spinal cord compression. Twenty-one patients had dissociation between loss of position and vibration sensation. All patients had one or more cervical luxations; five patients had atlanto-axial luxation alone, five had subaxial luxation alone and the remainder multiple luxations. Neurological improvement was more frequent and of longer duration in those treated by occipito-cervical fusion than in those treated conservatively but fitness for surgery may have selected a group with a better prognosis.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. C M Oostveen, M. A F J van de Laar, J. A G Geelen, and R. de Graaff Successful conservative treatment of rheumatoid subaxial subluxation resulting in improvement of myelopathy, reduction of subluxation, and stabilisation of the cervical spine. A report of two cases Ann Rheum Dis, February 1, 1999; 58(2): 126 - 129. [Abstract] [Full Text]
|
|