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Interesting Case* Surgery in Rheumatoid Cervical Spine with Spondylotic Myelopathy

Interesting Case* Surgery in Rheumatoid Cervical Spine with Spondylotic Myelopathy. Manoj Krishna,Spine Surgeon. Shailesh Hadgaonkar,Spine Fellow. Spinal Unit, University Hospital North Tees, Stockton OnTees. Clinical Story. 62 yr/m,came with Imbalance Neck pain-on & off

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Interesting Case* Surgery in Rheumatoid Cervical Spine with Spondylotic Myelopathy

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  1. Interesting Case*Surgery in Rheumatoid Cervical Spine with Spondylotic Myelopathy Manoj Krishna,Spine Surgeon. Shailesh Hadgaonkar,Spine Fellow. Spinal Unit, University Hospital North Tees, Stockton OnTees

  2. Clinical Story • 62 yr/m,came with • Imbalance • Neck pain-on & off • Difficulty in performing fine functions • He was diagnosed c/o RA

  3. Rhematoid Features Severe Changes ErosiveArthropathy- Radiocarpel,Intercarpel,Metacarpo phalyngeal jts Minor Enthesophytes-Patella

  4. Pre Op – Severe Spondylosis Lateral: Ap:

  5. MRI- multi-level compression of the spinal cord Sag T2 Multilevel affection

  6. MRI – T1 Sag & Axial Image Multilevel Spinal Canal Stenosis Cervical Cord Compression

  7. Intra-Op ,C-Arm Pic Complex anatomy Spondylotic Spine OPERATION- POSTERIOR DECOMPRESSION AND LATERAL MASS FIXATION

  8. Immediate Post op X ray-Day 1 Lateral: AP:

  9. “2 weeks post op”Good Decompression + Lat. Mass Fixation-PATIENT REPORTED SIGNIFICANT IMPROVEMENT IN SYMPTOMS Lateral: Ap :

  10. LEARNING POINTS • Cervical Myelopathy is common in patients with Rheumatoid Arthritis • Posterior decompression and stabilization offers a good alternative to anterior surgery

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