Comparative Study Of Single Posterior Surgical Versus Posterior Surgical Combined With Drug Therapy In Treatment Of Upper Cervical Spine Affection Of Rheumatoid Arthritis

objective: To compare the clinical effect of single posterior surgical approach with the posterior surgical approach with drug therapy in upper cervical spine due to rheumatoid arthritis.Methods: The retrospective study was conducted on 60 patients who were outpatients or in hospital from January 2006 to January 2016 in our hospital.All the patients were divided in two groups,24 patients(A group)were single posterior surgical group,and 36 patients(B group)were posterior surgical approach with drug therapy group,myelopathy of neurological scores was determined by JOA scores and pain was evaluated by VAS scores.The JOA scores and VAS scores?posterior atlantodens interval?anterior atlantodens interval?space available for the cord?Ranawat grade before and after surgery were compared.Results: the posterior surgical approach with medicine group had improved more significantly than the single posterior surgical approach,there was a significant difference in two groups(P<0.05).As the rheumatoid arthritis was a slowly progressive disease,the PADI,AADI,SAC and Ranawat value of the two groups were improved after the operation,but the statistical detection data was limited in the follow-up,there was no obvious difference in the two groups in short time and no statistical significance.Conclusion: Patients with rheumatoid arthritis in upper cervical spine affection would have a good improvement in clinical symptom,if the surgical method was conducted early.and the posterior surgical approach with medicine would get a better effect.