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Rheumatoid arthritis in the cervical spine
1Department of Orthopedic Surgery, Harvard Medical School, Brigham & Women's Hospital, Boston, MA 02115.
Clinical Orthopaedics and Related Research
|February 1, 1989
Summary
Rheumatoid arthritis can cause cervical spine subluxations, leading to pain and spinal cord dysfunction. Early surgical intervention is crucial for patients experiencing neurological decline to improve outcomes.
Area of Science:
- Orthopedics
- Rheumatology
- Neurology
Background:
- Rheumatoid arthritis frequently affects the cervical spine, causing synovitis and skeletal injury.
- Cervical spine subluxations are common in rheumatoid arthritis, potentially leading to pain and spinal cord dysfunction.
Purpose of the Study:
- To review the clinical presentation, diagnostic imaging, and surgical management of cervical spine involvement in rheumatoid arthritis.
Main Methods:
- Review of radiologic imaging techniques including computed tomography (CT) and magnetic resonance imaging (MRI) for anatomic assessment.
- Evaluation of indications for surgical intervention, including neurologic deterioration and pain.
Main Results:
- While subluxations are common, significant neurological problems and mortality are less frequent.
- Established myelopathy has a poor natural history, underscoring the need for timely intervention.
Conclusions:
- Advances in imaging have improved the assessment of cervical spine rheumatoid arthritis.
- Surgical intervention, often preceded by skeletal traction and followed by fusion, is indicated for neurologic deterioration and pain.