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- Article; Proceedings Paper] POSTMORTEM OSSEOUS AND NEUROPATHOLOGIC ANALYSIS OF THE RHEUMATOID CERVICAL-SPINE
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DocNo of ILP: 8028
Doc. Type: Article; Proceedings Paper
Title: POSTMORTEM OSSEOUS AND NEUROPATHOLOGIC ANALYSIS OF THE RHEUMATOID CERVICAL-SPINE
Authors: DELAMARTER, RB; BOHLMAN, HH
Full Name of Authors: DELAMARTER, RB; BOHLMAN, HH
Keywords by Author: CERVICAL; RHEUMATOID; AUTOPSY; PARALYSIS; SUBLUXATION
Keywords Plus:
Abstract: Methods. Eleven patients with paralysis, secondary to rheumatoid arthritis of the cervical spine were analyzed postmortem. Neurologic classification (Ranawat) included one Class 2, four Class IIIA, and six Class IIIB. Rheumatologic changes included atlantoaxial subluxation, basilar invagination, and subaxial subluxation. During autopsy the entire cervical spine was removed, including the occiput and foramen magnum. The spinal cord and medulla oblongata were removed en toto and examined histologically by a neuropathologist. Results. Nine of the eleven cases revealed abnormal histology of the spinal cord, and in two patients, the spinal cords were normal. Three histologic types of spinal cord compression were identified. In Type 1 (four cases) severe chronic mechanical compression revealed marked mechanical distortion, flattening, and destruction of the cord with secondary Wallerian degeneration of the ascending and descending tracts without anoxic-ischemic neuron changes. In Type 2 (three cases), there was vascular compression showing ischemic damage to the cord with necrosis of the lateral columns in the ischemic watershed regions supplied by anterior and posterior spinal arteries. In Type 3 (two cases), there was mild mechanical compression showing focal gliosis at the site of compression without ascending or descending tract injury. Two of the eleven cases had thrombosis of the vertebral arteries. Of the eleven cases analyzed, two had normal spinal cords. Conclusion. This autopsy analysis of rheumatoid cervical spine suggests that paralysis can be due to both mechanical neural compression and/or vascular impairment.
Cate of OECD: Clinical medicine
Year of Publication: 1994
Business Area: other
Detail Business: medicine & science
Country: USA
Study Area:
Name of Journal: SPINE
Language: English
Country of Authors:
Press Adress: DELAMARTER, RB (reprint author), W COAST SPINE INST,SUITE 755,100 UCLA MED PLAZA,LOS ANGELES,CA 90024, USA.
Email Address:
Citaion:
Funding:
Lists of Citation:
Number of Citaion: 0
Publication: LIPPINCOTT-RAVEN PUBL
City of Publication: PHILADELPHIA
Address of Publication: 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106
ISSN: 0362-2436
29-Character Source Abbreviation: SPINE
ISO Source Abbreviation: SPINE
Volume: 19
Version: 20
Start of File: 2267
End of File: 2274
DOI:
Number of Pages: 8
Web of Science Category: Clinical Neurology; Orthopedics
Subject Category: Neurosciences & Neurology; Orthopedics
Document Delivery Number: PM942
Unique Article Identifier: WOS:A1994PM94200004
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