![]() ![]() Terashima Y, Yurube T, Hirata H, Sugiyama D, Sumi M (2017) Predictive risk factors of cervical spine instabilities in rheumatoid arthritis: a prospective multicenter over 10-year cohort study. Nguyen HV, Ludwig SC, Silber J, Gelb DE, Anderson PA, Frank L, Vaccaro AR (2004) Rheumatoid arthritis of the cervical spine. Zhang T, Pope J (2015) Cervical spine involvement in rheumatoid arthritis over time: results from a meta-analysis. Prezerakos GK, Casey AT (2019) Diagnostics and Treatment of C1/C2-Instability in Rheumatoid Arthritis. Krauss WE, Bledsoe JM, Clarke MJ, Nottmeier EW, Pichelmann MA (2010) Rheumatoid arthritis of the craniovertebral junction. Mańczak M, Gasik R (2017) Cervical spine instability in the course of rheumatoid arthritis–imaging methods. Heinlen L, Humphrey M (2017) Skeletal complications of rheumatoid arthritis. In Surgery of the Cranio-Vertebral Junction. Nat Rev Rheumatol 11:276–289ĭas KK, Pandey S, Gupta S, Behari S (2020) Rheumatoid Cervical Myelopathy. Smolen JS, Aletaha D (2015) Rheumatoid arthritis therapy reappraisal: strategies, opportunities and challenges. ![]() McInnes IB, Schett G (2017) Pathogenetic insights from the treatment of rheumatoid arthritis. RA patients have higher complication rates and more frequent need for revision surgery than the general population of spine surgery patients. Patients with atlantoaxial instability have better functional and neurologic outcomes. Subaxial subluxation is managed with circumferential fusion or posterior only decompression and fusion. Cranial settling is managed can be managed with anterior decompression and posterior fusion or with dorsal only approaches. Atlantoaxial instability managed with atlantoaxial fusion, retroodontoid pannus with neural element compression is managed with posterior decompression and atlantoaxial fusion or occipitocervical fusion. Surgical management is indicated when patients experience symptoms from cervical involvement that result in biomechanical instability and, or a neurological deficit. Early diagnosis and treatment of cervical spine involvement is critical. Radiographs are the imaging modality used most often, while MRI and CT are used for assessment of neural element involvement and surgical planning. While many patients with cervical spine involvement are asymptomatic, symptomatic patients often present with nonspecific symptoms resulting from inflammation and additional secondary symptoms that are due to compression of the brainstem, cranial nerves, vertebral artery, and spinal cord. Synovial inflammation in the cervical spine causes instability and injuries including atlantoaxial subluxation, retroodontoid pannus formation, cranial settling, and subaxial subluxation. As many as 86% of patients suffering from RA have cervical spine involvement. doi:10.1016/j.mayocp.2016.06.007.Rheumatoid arthritis (RA) is a progressive autoimmune inflammatory disease affecting 1% of the population with three times as many women as men. Evidence-based evaluation of complementary health approaches for pain management in the United States. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Management of non-radicular neck pain in adults. Cervical spondylosis and spondylotic cervical myelopathy. Treatment and prognosis of cervical radiculopathy. American Academy of Orthopaedic Surgeons. ![]()
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