Treatment of the cervical spine in XXXX .

@entity1 @entity2622 @entity2737 @entity1274 @entity158 @entity309
Of thirty-four selected @entity1 who had @entity309 and @entity2622 , eighteen were treated operatively and sixteen were treated non-operatively. Of the subluxations of the atlanto-axial joint, nineteen were anterior; four, posterior; and eleven, vertical. Additionally, subaxial subluxations were seen in three @entity1 . At the time of treatment, the mean duration of the @entity309 was 19.4 years and the mean duration of the disorders of the cervical spine was 4.5 years. After treatment the @entity1 were followed for an average of 2.2 years (range, six months to six years). Of the thirty-four @entity1 , two (both of whom were treated non-operatively) died of causes unrelated to the lesions of the cervical spine and were excluded from this study. Of the remaining thirty-two @entity1 , eighteen were treated operatively and fourteen, non-operatively. The two groups were roughly comparable with respect to the lesions of the cervical spine, but more of the @entity1 who were treated surgically showed evidence of compression of the cord as demonstrated by computed tomography and myelography. The thirty-two @entity1 were not randomized in the two groups; therefore, comparison of the findings in these groups is not completely valid. Surgical treatment of the eighteen @entity1 included an atlanto-axial fusion in thirteen and an occipitocervical fusion in five. In addition, two @entity1 who had an occipitocervical fusion also had a subaxial laminectomy and posterior fusion. There was a superficial @entity2737 , which was treated successfully with short-term antibiotic therapy, in two @entity1 . No @entity1 died postoperatively. @entity158 was relieved in twelve of the fifteen operatively treated @entity1 who had @entity158 , whereas @entity158 was relieved in only one of the eight conservatively treated @entity1 who had @entity158 . At follow-up, neurological function was unchanged or improved in the operatively treated group but was slightly worse in the conservatively treated group. We concluded that fusion of an unstable rheumatoid cervical spine relieves @entity158 and prevents progression of existing @entity1274 without undue risk for the @entity1 .
