A 63 year-old woman had a 30 year history of rheumatoid arthritis and was in stage 4 and class 4. Her neurological summary at hospitalization was C3 central cord syndrome including respiratory disturbance. The most remarkable findings of the radiographs were the backward dislocation of the atlas due to disappearance of the odontoid process and the lateral tilting of the occiput toward the right side (24 degree) due to severe collapse of the lateral masses of C1, C2 and C3.
No complete block was encountered in the myelogram and also no marked insufficiency of the vertebral artery was found by angiogram.
Her neurological disorders improved after putting her into a Halo-jacket to prevent further displacement by serious destruction of the upper cervical spine. She recovered from the condition of total dependency to partial independence, namely she can feed herself using orthosis.