Anterior occipitocervical fusion in rheumatoid arthritis: report of a case

A case of rheumatoid arthritis with cervical spine involvement leading to quadriparesis is reported. Cord pressure necessitated laminectomy to achieve decompression. This was done with a partial reversal of the neurological abnormalities. Since structural disease of bone was present, stabilization was mandatory. The laminectomy had rendered posterior fusion unlikely to succeed; hence a method was devised to fuse the occipital and upper cervical region from the front through an extraoral approach.