852, 0.715, 0.731 respectively). Table 2 contains the maximum and minimum limits of laminar thickness and length. selleck chemical Cisplatin Table 3 presents the values of the same parameters in healthy individuals obtained in a previous study.10 Table 2 Maximum and minimum values of thickness and length obtained Table 3 Comparison between the means of thickness, length and spinolaminar angle obtained in healthy patients and patients with rheumatoid arthritis DISCUSSION In the current literature we found various studies that use imaging methods to characterize the degenerations of the atlanto-axial joint of patients with rheumatoid arthritis.1-3,11,12 However, these studies are focused on the degenerative alterations of the joint and the development of instability.

We do not find any study indicating the need for special precautions did the passage of intralaminar screws in patients with rheumatoid arthritis, such as passage of screws of reduced diameter or length due to deformities in the medullary canal of the C2 laminae. It is a small study, with 20 cases, and only three male patients. Due to the disproportion between the sexes, it was not possible to conduct a comparative analysis between men and women. In the non-statistical comparison, with the results found in healthy individuals for the same parameters, published in a previous study by our group,10 we realized that the values obtained are equivalent, suggesting that in spite of the multiple joint alterations that develop with the pathology, there is no significant alteration of the morphology of the C2 vertebra.

The results of this study aim to corroborate the idea that the atlanto-axial stabilization procedures currently considered safe for healthy patients, are also safe for patients with rheumatoid arthritis, besides demonstrating that the passage of C2 intralaminar screws is safe, in observing that the minimum sizes found are larger than most of the screws used in this region (minimum thickness 3.7mm, minimum length 26.6mm). CONCLUSION The results obtained in the morphological analyses of C2 in patients with rheumatoid arthritis are similar to those of healthy patients, suggesting that there is no need to alter the placement technique of C2 intralaminar screws in patients with rheumatoid arthritis. Footnotes All the authors declare that there is no potential conflict of interest referring to this article.

Study conducted at LIM 41 �C Laboratory of Medical Investigation of the Musculoskeletal System of the Department of Orthopedics and Traumatology of the School of Medicine of Universidade de S?o Paulo.
The immobilization of a body segment is a procedure Dacomitinib generally used for the treatment of musculoskeletal injuries, although it can result in undesirable structural alterations1 such as muscle atrophy,2 change in the number of sarcomeres in series,2 reduction in the glycogen reserve,3 increase of connective tissue, diminished strength2,3 and muscle weight.