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Inflammatory bowel disease and the craniocervical junction
Journal article   Open access   Peer reviewed

Inflammatory bowel disease and the craniocervical junction

Timothy Ryken and Arnold Menezes
Neurosurgical focus, Vol.6(6), pp.e10-e10
06/15/1999
DOI: 10.3171/foc.1999.6.6.13
PMID: 16972747
url
https://doi.org/10.3171/foc.1999.6.6.13View
Published (Version of record) Open Access

Abstract

Rheumatological complications have been described in up to 30% of patients being followed for inflammatory bowel disease. The majority of these complications occur as spondylitic changes in the lumbar spine. Erosive arthritic disease associated with inflammatory bowel disease occurs less frequently, but it can result in ligamentous laxity and joint instability. To highlight the potential significance of the process at the craniocervical junction, the authors describe the long-term follow-up care of a complicated case. A 56-year-old woman, with a long history of ulcerative colitis, presented with atlantoaxial instability and underwent a C1-3 fusion; however, the presence of significant occipitoatlantal instability was not recognized. This resulted in high cervicomedullary quadriplegia, requiring traction reduction and a combined anterior transoral decompressive-posterior occipitocervical fusion. The patient's neurological deficit completely resolved postoperatively.

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