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Rheumatoid Spondylitis

90% of rheumatoids have cervical spine involvement

Indications for surgical stabilisation:

  1. instability

  2. pain

  3. neurological deficit due to nerve compression

50-80% of rheumatoid c-spine disorders


  • due to pannus formation at the synovial joints betw. the dens & the ring of C1

  • destruction of the transverse ligament & the dens

  • Anterior subluxation on C1 on C2


  • reduced ROM

  • UMN signs (myelopathy)

  • 'clunk' with neck flexion (Sharp & Purser sign - not recommended!)

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