[Alterations to the lumbar spine in rheumatoid arthritis]

In rheumatoid arthritis the anatomical structures of the lumbar spine are affected by the same mechanisms of destruction as are known from other skeletal regions. Although spinal symptoms do not become apparent until the later stages of rheumatoid arthritis, patients do sometimes complain of typical symptoms. We present data recorded in 19 patients with seropositive rheumatoid arthritis who underwent hospital treatment directed exclusively at isolated low-back pain. The patients were questioned in some detail with the aid of instruments including the Oswestry, TypE, HAQ and RADAI questionnaires and a visual-analogue-pain scale. Roentgen exposures were also evaluated. A comparison was drawn between patients treated surgically with decompression and various spondylodeses (n=13) and those who received conservative treatment (n=6). Better results were obtained in the group of patients treated surgically, though a statistical evaluation was not possible. No histological evidence of rheumatoid alterations was found in the intervertebral disc tissue samples available.