Atlanto Axial Instability

A 61-year-old gentleman with rheumatoid arthritis complaining of neck pain and gait instability. He also had clumsiness of hand movement and spasticity.

Investigations revealed instability between the first and second cervical vertebra causing dynamic compression of the cervical spinal cord.

C1 - C2 stabilization and fusion were done using C1 lateral mass and C2 translaminar screw fixation. Postoperative CT scan and X-ray show good C1 - C2 reduction.

Patients with rheumatoid arthritis can at times suffer from such cervical spine instability which needs surgical treatment.