A Case of Odontoid Fracture in Rheumatoid Arthritis / 대한류마티스학회지

ABSTRACT

It's now well recognized that the cervical spine is commonly affected in rheumatoid arthritis(RA) and that subluxation of the atlas is frequently present and may occasionally be fatal. It is not widely appreciated, however, that some rheumatoid patients may develop fractures of the odontoid process in association with relatively minimal trauma or no trauma at all. This is a fracture caused by erosion and osteoporosis of the odontoid process due to rheumatoid synovitis, aging and steroid therapy. In addition, another cause is a dynamic load produced from the instability accompanying atlantoaxial subluxation working on the odontoid in cervical extension. We evaluated a patient with RA who had a fracture of the odontoid process. Following diagnosis she underwent surgery for which the prognosis was excellent.