Document Detail

Cervical spine involvement in rheumatoid arthritis. A review.
MedLine Citation:
PMID:  12027304     Owner:  NLM     Status:  MEDLINE    
Cervical spine involvement occurs in over half of patients with rheumatoid arthritis (RA). The most common abnormality is atlantoaxial dislocation, followed by atlantooccipital arthritis with cranial settling and by lesions of the lower cervical spine. Cervical spine involvement usually occurs in patients with severe RA. Pain and evidence of spinal cord injury are the main symptoms. The presence of symptoms is not correlated with the severity of radiological abnormalities. Computed tomography and magnetic resonance imaging provide detailed images of the bone and spinal cord lesions. Because the course is unpredictable, conservatively treated patients usually require regular follow-up. Surgery is in order in patients with pain unresponsive to major narcotics or with progressive neurological impairment. The choice between the anterior and the posterior route depends on the experience of the surgical team. It is reasonable to stabilize the spine before the development of cranial settling or major neurological loss (Ranawat's stage III). The good functional results of spinal surgery are frequently overshadowed by major impairments related to severe peripheral joint disease. Safety is acceptable when somatosensory evoked responses are monitored intraoperatively. Surgery can provide substantial improvements in symptoms, particularly pain.
Agnès Bouchaud-Chabot; Frédéric Lioté
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Joint, bone, spine : revue du rhumatisme     Volume:  69     ISSN:  1297-319X     ISO Abbreviation:  Joint Bone Spine     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-05-24     Completed Date:  2002-11-07     Revised Date:  2006-10-11    
Medline Journal Info:
Nlm Unique ID:  100938016     Medline TA:  Joint Bone Spine     Country:  France    
Other Details:
Languages:  eng     Pagination:  141-54     Citation Subset:  IM    
Fédération de Rhumatologie, Centre Viggo-Petersen, Hĵpital Lariboisière, Paris, France.
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MeSH Terms
Arthritis, Rheumatoid / complications*,  radiography,  surgery
Atlanto-Axial Joint / radiography,  surgery
Cervical Vertebrae* / radiography,  surgery
Follow-Up Studies
Joint Instability / complications*,  radiography,  surgery
Pain / etiology
Spinal Cord Injuries / etiology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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