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Rheumatoid arthritis-associated cervical spine deformity and flares in disease activity
Anna B Lebouille-Veldman1, Dylan Spenkelink2, Tom W J Huizinga3
1Department of Neurosurgery, Leiden University Medical Centre, Leiden, the Netherlands.
Brain & Spine
|April 10, 2025
Summary
Fewer rheumatoid arthritis (RA) patients with more disease flares showed cervical spine deformity. Increased medication use during flares may protect the cervical spine, but further research is needed.
Area of Science:
- Rheumatology
- Orthopedics
- Radiology
Background:
- Rheumatoid arthritis (RA) can cause cervical spine deformities like atlantoaxial subluxation (AAS) and subaxial subluxation (SAS).
- Identifying patients at risk for these deformities remains challenging despite early RA treatment.
Purpose of the Study:
- To investigate the association between the frequency of disease activity flares and RA-associated cervical spine deformity.
- To evaluate if disease flares impact the development of AAS and SAS in RA patients.
Main Methods:
- Sub-analysis of the BeSt Study involving 272 RA patients.
- Lateral X-rays assessed for AAS and SAS at 5- and 10-year follow-ups.
- Statistical analysis adjusted for age, gender, ACPA, and RF status.
Main Results:
- 40% of RA patients (108/272) exhibited cervical spine deformity (AAS/SAS >2 mm).
- A trend suggested less cervical deformity in patients experiencing 3 or more flares.
- This trend was not statistically significant (OR 0.338, 95% CI: 0.095-1.207).
Conclusions:
- A trend towards reduced RA-associated cervical deformity was observed with more frequent flares.
- Increased medication use during flares might offer protection to the cervical spine.
- Further research is recommended to explore medication's effect on cervical deformity in RA.
Keywords:
Atlantoaxial subluxationCervical spine deformityDisease activityRheumatoid arthritisVertical translocationMore Related Videos
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