Radiological features of lumbar spinal lesions in patients with rheumatoid arthritis with special reference to the changes around intervertebral discs

Sakai, Toshinori; Sairyo, Koichi; Hamada, Daisuke; Higashino, Kosaku; Katoh, Shinsuke; Takata, Yoichiro; Shinomiya, Fumio; Yasui, Natsuo

doi:10.1016/j.spinee.2007.03.008

Cited by 44 publications

(29 citation statements)

References 18 publications

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“…Spinal block is quite reproducible in an individual patient [18], but patientrelated characteristics, for example age, weight, BMI, and height, create interindividual variation acting through CSF volume so that lower volume promotes greater spread of block [1]. It is probable that inflammatory and degenerative changes observed in the thoracic [19,20] and lumbar [21][22][23][24] rheumatoid spine may narrow the lumbosacral and thoracic subarachnoid space reducing CSF volume, thus contributing to the peak sensory block level.…”

Section: Discussionmentioning

confidence: 99%

The effect of body mass index on the spread of spinal block in patients with rheumatoid arthritis

et al. 2010

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Section: Discussionmentioning

confidence: 99%

The effect of body mass index on the spread of spinal block in patients with rheumatoid arthritis

et al. 2010

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“…One is the involvement of an inflammatory response in the disc lesion. This theory is supported by the observation that inflammatory tissue in the rheumatoid thoracic spine appeared to originate in the costovertebral articulations and extended into the nearby discovertebral junction [20]. The other theory is that discovertebral alterations are related to traumatic events produced by instability in the posterior elements of the spine.…”

Section: Discussionmentioning

confidence: 96%

Characteristics of lumbar scoliosis in patients with rheumatoid arthritis

Ohishi

Miyahara

Kondo

et al. 2014

Journal of Orthopaedic Surgery and Research

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BackgroundAlthough a substantial percentage of patients with rheumatoid arthritis (RA) experience low back pain, the characteristics of lumbar spine pathology in RA patients has been poorly investigated. In our institutions, lumbar spine radiographs indicated scoliosis in 26 patients. The present study aimed to clarify the characteristics of lumbar scoliosis in RA patients.MethodsThis is a retrospective study of 26 RA patients with lumbar scoliosis. Patient characteristics such as disease duration, disease stage and class according to Steinbrocker's classification, and medication for RA and osteoporosis were reviewed. Radiologic evaluation of scoliosis was performed at two different time points by measuring Cobb angles. The progression of scoliosis per year was calculated by dividing the change in Cobb angles by the number of years. Apical vertebral rotation, lateral listhesis, and the level of the intercrestal line at the first observation were also measured. The correlation between different factors and changes in the Cobb angles per year was analyzed.ResultsMajority of the patients had a long disease duration and were classified as stage 3 or 4 according to Steinbrocker's classification. During the observation period, most patients were treated with glucocorticoids. Unlike the previous studies on degenerative scoliosis, apical vertebral rotation, lateral listhesis, and the level of the intercrestal line at initial observation were not significantly related to the progression of scoliosis. Initial Cobb angles were inversely related to the progression of scoliosis. Patients who were treated with bisphosphonates showed slower progression of scoliosis.ConclusionsOur results indicate that the characteristics of lumbar scoliosis in RA patients differ from those of degenerative lumbar scoliosis. Bone fragility due to the long disease duration, poor control of disease activity, and osteoporosis is possibly related to its progression.

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“…With regard to the disease incidence, Heywood and Meyers reported a frequency of 0.94% (seven cases in 746 patients satisfying the criteria of definite rheumatoid arthritis) (2). Recently, Nakase et al and Sakai et al suggested that asymptomatic involvement is relatively common (7, 8). Usually, a radiological examination shows disc narrowing without osteophyosis, spondylolisthesis, osteoporosis and ill-defined margins of the apophyseal joints (2, 3).…”

Section: Discussionmentioning

confidence: 99%

“…However, a review of the literature showed that rheumatoid synovitis with erosive changes can develop in these diarthrodial joints. The vertebral bodies and intervertebral discs may be involved through either enthesitis or an extension of the inflammatory process from the apophyseal joints (2, 3, 5-7). There are few reports describing collapse of the vertebrae affected by RA without synovitis and enthesitis (1, 4, 5, 8).…”

Section: Introductionmentioning

confidence: 99%

Multiple Vertebral Involvement of Rheumatoid Arthritis in Thoracolumbar Spine: A Case Report

2010

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Although little attention has been paid to the less common rheumatoid involvement of the thoracic and lumbar regions, some studies have shown that rheumatoid synovitis with erosive changes can develop in these diarthrodial joints. We report a patient with seropositive rheumatoid arthritis (RA) involving the thoracic and lumbar vertebra with a collapse of the T12 vertebra, who was treated with percutaneous vertebroplasty. In this case of a painful pathological fracture due to RA, percutaneous vertebroplasty was found to be helpful in eliminating the pain. The paper presents the histological evidence, the pathogenesis and treatment of the thoracolumbar lesions affected by RA with a review of the relevant literature.

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Radiological features of lumbar spinal lesions in patients with rheumatoid arthritis with special reference to the changes around intervertebral discs

Cited by 44 publications

References 18 publications

The effect of body mass index on the spread of spinal block in patients with rheumatoid arthritis

The effect of body mass index on the spread of spinal block in patients with rheumatoid arthritis

Characteristics of lumbar scoliosis in patients with rheumatoid arthritis

Multiple Vertebral Involvement of Rheumatoid Arthritis in Thoracolumbar Spine: A Case Report

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