Rheumatoid arthritis of the cervical spine

Rheumatoid arthritis most often affects the cervical spine, resulting in clinical and radiographic findings. For most patients with rheumatoid arthritis the cervical involvement represents a relatively benign process, but, in a small percentage of these patients, a progressive instability pattern develops that may compromise neural or vascular structures. The rate of neural compromise because of cervical instability ranges from 11% to 58%. The clinical manifestation may be radiculopathy, myelopathy, quadriplegia, and, in extreme instances, sudden death.