Spontaneous arthrodesis of atlanto-axial complex in a case of rheumatoid arthritis

摘要

Atlanto-axial dislocation (AAD) and superior migration of odontoid (cranial settling) and sub-axial subluxation in rheumatoid arthritis (RA) can present with cervical myelopathy. The underlying pathology includes destruction of synovial joints, ligamentous laxity, and pannus formation. Usual treatment of these patients includes fusion of atlanto-axial joint with implants, aiming for a goal of achieving bony fusion of atlanto-axial complex. We present a patient of RA with spontaneous arthrodesis of C1-C2 (atlanto-axial) complex with extensive pan-ligamental and soft tissue calcification around the C1-C2 complex with anterior migration of atlas causing high cervical compressive myelopathy.