Atlantoaxial Instability Medication

Updated: Jun 06, 2022
  • Author: Daniel P Leas, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Medication Summary

No role currently exists for medications in the treatment of AAI. Whereas nonsteroidal anti-inflammatory drugs (NSAIDs) are used in atlantoaxial rotary subluxation to control the inflammation, evidence to support this practice is lacking.

Kaito et al found a de novo rate of cervical lesions of 8% in a small retrospective study of 38 RA patients receiving some form of biologic therapy. There was still a high disease progression rate in patients that were already on the spectrum of cervical disease (81%). [16, 17]

Unfortunately, an intervention-versus-control trial is ethically impossible, given the known benefits of biologic therapy in other targets of rheumatoid disease. Thus, the impact of these agents on development and cervical progression has yet to be truly determined. Long-term case studies compared to historical matched controls will be required to make any further comparison.