Occipitocervical fusion has potential to improve sleep apnea in patients with rheumatoid arthritis and upper cervical lesions.

摘要

STUDY DESIGN: Case series. OBJECTIVE: To analyze factors that contribute to the development of sleep apnea in patients with rheumatoid arthritis (RA) and upper cervical lesions. SUMMARY OF BACKGROUND DATA: No large prospective study has analyzed the association between sleep apnea and upper cervical involvement resulting from RA. Furthermore, only 1 report in the literature describes a case of sleep apnea accompanying rheumatoid vertical subluxation of the odontoid process. METHODS: The authors analyzed 8 consecutive RA patients with upper cervical lesions who underwent occipitocervical (O-C) fusion. The patients were examined with all-night polysomnography before and after surgery. Patients with apnea-hypopnea index values>or=5 were diagnosed to have sleep apnea. O-C2 angles were calculated from cervical radiographs. RESULTS: All 8 patients were diagnosed as having sleep apnea, and most of their apneic episodes were obstructive in origin. Among the 4 patients with medullary compression, central apneic episodes comprised