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Resolution of a periodontoid rheumatoid pannus mass in an elderly patient treated with a rigid cervical collar: A case report and literature review

Abidemi Oseni, Georg Kakavas, Martin Scholz, Athanasios Petridis

Abstract


In patients with C2 rheumatoid pannus with spinal cord compression the treatment of choice is extensive surgery either through a transoral resection of the dens axis or a dorsal stabilisation, or both. We present a case of an 11-mm rheumatoid pannus with significant compression of the spinal cord, which failed surgical treatment with respect to dorsal stabilisation. Therefore, rigid cervical collar for 8 weeks followed by soft collar for another 4 weeks was chosen as a treatment option. During the follow-up period of 1 year, the pannus reduced significantly and the spinal cord decompressed. In cases where surgery is not an option or is technically very demanding, the alternative of cervical collar immobilisation is a satisfying option.



Authors' affiliations

Abidemi Oseni, Division of Neurosurgery, Department of Surgery, Lagos University Teaching Hospital, Nigeria

Georg Kakavas, Department of Neurosurgery, Sana Kliniken Duisburg, Duisburg, Germany

Martin Scholz, Department of Neurosurgery, Sana Kliniken Duisburg, Duisburg, Germany

Athanasios Petridis, Department of Neurosurgery, Sana Kliniken Duisburg, Duisburg, Germany

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Keywords

Rheumatoid arthritis; Pannus; Atlantoaxial instability; Cervical collar

Cite this article

South African Medical Journal 2016;106(7):687-688. DOI:10.7196/SAMJ.2016.v106i7.9861

Article History

Date submitted: 2015-06-26
Date published: 2016-06-17

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