Vertebral Artery Obstruction due to Anterior and Vertical Subluxation of Atlanto-Axial and Atlanto-Occipital Joint in Ankylosing Spondylitis.
- Author:
Sung Choon PARK
1
;
Seong Hoon OH
;
Dae Cheol RIM
;
Dae Hyun YOO
;
Euy Byung CHAE
;
Nam Kyu KIM
Author Information
1. Department of Neurosurgery, Myongji Hospital, Kwandong University, Koyang, Korea.
- Publication Type:Case Report
- Keywords:
Ankylosing spondylitis;
Atlanto-axial subluxation;
Atlanto-occipital subluxation;
Vertical subluxation;
Vertebral artery obstrction
- MeSH:
Arthritis, Rheumatoid;
Atlanto-Occipital Joint*;
Axis, Cervical Vertebra;
Deglutition;
Follow-Up Studies;
Foramen Magnum;
Humans;
Infarction;
Male;
Middle Aged;
Prognosis;
Spinal Cord Compression;
Spondylitis, Ankylosing*;
Tongue;
Vertebral Artery*
- From:Journal of Korean Neurosurgical Society
1999;28(7):1023-1026
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: We report a case with a long-standing history of the ankylosing spondylitis(AS) who showed multiple cerebellar infarctions with bulbar symptom owing to vertebral artery obstruction, due to anterior and vertical subluxation of atlanto-axial and atlanto-occipital joint. CLINICAL PRESENTARION: An 51-year-old male patient with swallowing difficulty, tongue deviation to the left side and severe nuchal pain and rigidity is presented. INTERVENTION: After removal of posterior portion of foramen magnum, posterior portion of left transverse foramen of axis was decompressed. CONCLUSIONS: Spontaneous anterior atlanto-axial subluxation occurs in patients with AS about 2% of presents with or without signs of spinal cord compression. Vertical subluxation occurs in 3-8% of patient with rheumatoid arthritis but it is an exceedingly rare complication of AS. Close observation and follow-up are needed in patients with AS and if subluxation occurs, good prognosis is anticipated using an early operative treatment.
