Rheumatoid Arthritis of the Cervical Spine in the Adult

Sharp, J.; Purser, D. W.; Lawrence, John S.

doi:10.1136/ard.17.3.303

Cited by 96 publications

(40 citation statements)

References 11 publications

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“…Endplate erosions have been reported in 11-21% of patients with RA whereas disc space narrowing tends to be more common; it occurs in 18-25% of patients (6,7,9,12,19). However, in our patients, discitis was uncommon, present in only 5 patients, 2 of whom developed myelopathy .…”

contrasting

confidence: 43%

“…The vertical movement of the odontoid is dependent on the destruction of the lateral articular masses or bone around the foramen magnum (15). The frequency of subaxial subluxation ranges from 7-29%, depending on the type of patient studied (6,9,10,12,14,19). Our figure of 7% may reflect the fact that our patients were not selected for cervical spine complaints.…”

mentioning

confidence: 87%

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Nonreducible rotational head tilt and lateral mass collapse. a prospective study of frequency, radiographic findings, and clinical features in patients with rheumatoid arthritis

Halla

Fallahi

Hardin

1982

Arthritis & Rheumatism

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Of 126 hospitalized, but otherwise unselected, patients with rheumatoid arthritis, 12 (10%) had a persisting nonreducible rotational head tilt deformity (NRRHT). These 12 were grouped with an additional 12 similar subjects, previously found to have the same condition, and all 24 were compared with the remaining 114 who did not have head tilt. Patients with NRRHT differed significantly from the others in that the former were more likely to have a destructive peripheral arthritis, headache, limited neck motion, and various cervical subluxations. All 24 subjects with NRRHT had predominately unilateral collapse of the lateral masses of the atlas andlor axis, compared with only 2 of the 114 with normal head position. The head always tilted to the side of the lateral mass collapse, which appeared to be the sole or major cause of the abnormal head position.Cervical spine involvement in rheumatoid arthritis (RA) is recognized as common, and chronic proliferative inflammatory changes may involve all of the synovial tissue of the cervical spine (1,2). Radiographic evidence of this process includes odontoid

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confidence: 43%

mentioning

confidence: 87%

Nonreducible rotational head tilt and lateral mass collapse. a prospective study of frequency, radiographic findings, and clinical features in patients with rheumatoid arthritis

Halla

Fallahi

Hardin

1982

Arthritis & Rheumatism

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“…The most common disorders include atrantoaxial (C1/2) instability and subluxation in the mid-and lower-cervical spine [6,21]. These conditions sometimes cause myelopathy, severe pain, or both, either of which impairs the quality of life of RA patients [19].…”

Section: Introductionmentioning

confidence: 99%

Computer-assisted screw insertion for cervical disorders in rheumatoid arthritis

et al. 2006

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To reconstruct highly destructed unstable rheumatoid arthritis (RA) cervical lesions, the authors have been using C1/2 transarticular and cervical pedicle screw fixations. Pedicle screw fixation and C1/2 transarticular screw fixation are biomechanically superior to other fixation techniques for RA patients. However, due to severe spinal deformity and small anatomical size of the vertebra, including the lateral mass and pedicle, in the most RA cervical lesions, these screw fixation procedures are technically demanding and pose the potential risk of neurovascular injuries. The purpose of this study was to evaluate the accuracy and safety of cervical pedicle screw insertion to the deformed, fragile, and small RA spine lesions using computer-assisted image-guidance systems. A frameless, stereotactic image-guidance system that is CT-based, and optoelectronic was used for correct screw placement. A total of 21 patients (16 females, 5 males) with cervical disorders due to RA were surgically treated using the image-guidance system. Postoperative computerized tomography and plane X-ray was used to determine the accuracy of the screw placement. Neural and vascular complications associated with screw insertion and postoperative neural recovery were evaluated. Postoperative radiological evaluations revealed that only 1 (2.1%; C4) of 48 screws inserted into the cervical pedicle had perforated the vertebral artery canal more than 25% (critical breach). However, no neurovascular complications were observed. According to Ranawat's classification, 9 patients remained the same, and 12 patients showed improvement. Instrumentation failure, loss of reduction, or nonunion was not observed at the final followup (average 49.5 months; range 24-96 months). In this study, the authors demonstrated that image-guidance systems could be applied safely to the cervical lesions caused by RA. Image-guidance systems are useful tools in preoperative planning and in transarticular or transpedicular screw placement in the cervical spine of RA patients.

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“…Although the involvement of the middle and lower cervical spine can cause subaxial instability, neurological deficits can occur at any time [4]. These disorders produce myelopathy and severe occipital/neck pain, and reduce the quality of life (QOL) of these patients [5][6][7]. Furthermore, these disorders occasionally lead to quadriplegia and respiratory muscle paralysis.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine

et al. 2013

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Rheumatoid Arthritis of the Cervical Spine in the Adult

Cited by 96 publications

References 11 publications

Nonreducible rotational head tilt and lateral mass collapse. a prospective study of frequency, radiographic findings, and clinical features in patients with rheumatoid arthritis

Nonreducible rotational head tilt and lateral mass collapse. a prospective study of frequency, radiographic findings, and clinical features in patients with rheumatoid arthritis

Computer-assisted screw insertion for cervical disorders in rheumatoid arthritis

Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine

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