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Morio Matsumoto, Kazuhiro Chiba, Takashi Tsuji, Hirofumi Maruiwa, Yoshiaki Toyama and Jun Ogawa

RA neck pain TAS + TMC no no no yes * OO = os odontoideum; TAS = transarticular screw fixation; TMC = titanium mesh cage. Radiography demonstrated a mean anterior atlantoaxial subluxation of 10.5 mm (range 8–13 mm). Postoperatively, solid bone union was confirmed both by the presence of continuous osseous trabeculae between C-1 and C-2 through a mesh cage and by immobility between C-1 and C-2 on flexion—extension lateral radiography. The meshtype construct of the cage and the use of digital computerized radiography (Fuji Film

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Kenya Nojiri, Morio Matsumoto, Kazuhiro Chiba, Hirofumi Maruiwa, Masaya Nakamura, Takashi Nishizawa and Yoshiaki Toyama

4. Kraus DR , Peppelman WC , Agarwal AK , et al : Incidence of subaxial subluxation in patients with generalized rheuma-toid arthritis who have had previous occipital cervical fusions. Spine 16 : S486 – S489 , 1991 Kraus DR, Peppelman WC, Agarwal AK, et al: Incidence of subaxial subluxation in patients with generalized rheuma-toid arthritis who have had previous occipital cervical fusions. Spine 16: S486–S489, 1991 5. Krieg JC , Clark CR , Goetz DD : Cervical spine arthrodesis in rheumatoid

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Morio Matsumoto, Kazuhiro Chiba, Masaya Nakamura, Yuto Ogawa, Yoshiaki Toyama and Jun Ogawa

-old woman with atlantoaxial subluxation due to RA. She underwent atlantoaxial arthrodesis involving TSF and placement of an interlaminar titanium mesh cage. Left: Preoperative lateral radiograph demonstrating remarkable atlantoaxial subluxation. Center: Lateral radiograph obtained 2 years after surgery. Solid bone union was achieved and good alignment of the upper and lower cervical spine was well maintained. Right: Open mouth radiograph revealing positioning of the hardware. In a biomechanical study of atlantoaxial fixation, Naderi, et al., 9 reported that

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Ken Ishii, Kazuhiro Chiba, Hirofumi Maruiwa, Masaya Nakamura, Morio Matsumoto and Yoshiaki Toyama

R otatory subluxation of the atlantoaxial joint can occasionally persist, causing torticollis that is resistant to treatment. Such persistent subluxation, which is observed in children, was termed AARF by Fielding and Hawkins 9 in 1977. Children with AARF present with torticollis and limited neck motion with or without pain. They exhibit the so-called cock-robin deformity—that is, rotation of the head to one side and lateral flexion to the other. The mechanism that causes subluxation is not fully understood and may be due to a muscle spasm. 9 , 23 , 26

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Keitaro Matsukawa, Yoshiyuki Yato, Hideaki Imabayashi, Naobumi Hosogane, Takashi Asazuma and Kazuhiro Chiba

anterior vertebral subluxation. Pedicle screw systems have typically been used to reconstruct the vertebral column against such anterior slipping. The present study is the first to evaluate the fixation strength of pedicle screws inserted through different trajectories into the spondylolytic vertebra. Cadaveric spines are useful for evaluating the biomechanical behavior of pedicle screws, but there are some difficulties that may cause biased study results, including insufficient sample size, wide individual variations of bone quality and age, and validity of