Atteinte radiologique du rachis lombaire au cours de la polyarthrite rhumatoïde

Harzy, Taoufik; Allali, F.; Bennani-Othmani, Mohammed; Hajjaj–Hassouni, N.

doi:10.1016/j.lpm.2007.04.014

Cited by 7 publications

(3 citation statements)

References 16 publications

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“… 6 , 13 , 23) On the other hand, Harzy et al described radiological lumbar lesions, expect for vertebral fracture, were not more frequent among RA patients than among control populations. 5) Introduction of biological drugs and early treatment by early diagnosis improve treatment results for RA. 4 , 22 , 24) The number of severeRA-related cervical lesions, in which the main pathology is synovitis, is expected to decrease with early treatment and introduction of biological drugs.…”

Section: Discussionmentioning

confidence: 99%

The Pitfalls in Surgical Management of Lumbar Canal Stenosis Associated With Rheumatoid Arthritis

Mitsuyama

Kubota

Yuzurihara

et al. 2013

Neurol. Med. Chir.(Tokyo)

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There have been few clinical studies in the area of cervical spine that focused on surgery for treating degenerative lumbar disease in patients with rheumatoid arthritis (RA). High rates of wound complications and instrumentation failure have been reported more for RA than for non-RA patients, although clinical outcomes are similar between the two groups. Lumbar canal stenosis in RA is caused not only by degeneration but also by RA-related spondylitis, which includes facet arthritis and inflammation around the vertebral endplate. The pitfalls in surgical management of lumbar canal stenosis in RA patients are highlighted in this study. The study reviewed 12 patients with RA,who were surgically treated for lumbar canal stenosis. Two out of five patients with pulmonary fibrosis died of worsened pulmonary condition, even though there were no perioperative pulmonary complications. Two patients with pedicle screw fixation showed no instrumentation failure, but two patients with spinous process fixation needed re-operation or vertebral fracture. Surgical treatment for lumbar canal stenosis in RA patients needs to be individually adjusted. Preoperative assessments and treatments of pulmonary fibrosis and osteopenia are essential. Surgery for lumbar canal stenosis with RA should be deferred for patients with advanced pulmonary fibrosis because of its potential life-threatening risk. Fusion surgery is indicated only in patients with kyphosis or severe symptoms caused by intervertebral instability. Pedicle screw fixation with hydroxyapatite granules or sublaminar tape is recommended. Closer follow-up after surgery is necessary because of possible delayed wound infection, instrumentation failure, pathological fracture, and respiratory deterioration.

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Section: Discussionmentioning

confidence: 99%

The Pitfalls in Surgical Management of Lumbar Canal Stenosis Associated With Rheumatoid Arthritis

Mitsuyama

Kubota

Yuzurihara

et al. 2013

Neurol. Med. Chir.(Tokyo)

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“… 36 , 37 General radiological lumbar lesions were not more prevalent among RA patients compared with population controls, though vertebral fractures were more frequent in RA patients. 38 Disc space narrowing and severity of endplate erosion were correlated with higher RA severity scores (Larsen grades). 4 , 38 Larsen grade of the wrist was also found to be higher in patients with lumbar facet erosion, compared to patients without these lesions.…”

Section: Imagingmentioning

confidence: 95%

“… 38 Disc space narrowing and severity of endplate erosion were correlated with higher RA severity scores (Larsen grades). 4 , 38 Larsen grade of the wrist was also found to be higher in patients with lumbar facet erosion, compared to patients without these lesions. 4 This is likely because facet joints are synovial joints consisting of fibrocartilage that are very similar to peripheral joints and as such undergo similar inflammatory reactions resulting from RA.…”

Section: Imagingmentioning

confidence: 95%

Surgical Management of the Lumbar Spine in Rheumatoid Arthritis

Joo

Mesfin

2019

Global Spine Journal

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Study Design: Narrative review. Objective: To provide an overview on the diagnosis and surgical management of rheumatoid involvement of the lumbar spine. Rheumatoid arthritis (RA) is a chronic inflammatory disease of synovial joints, most commonly appendicular followed by axial. Although cervical spine involvement of RA is well documented, data on lumbar spine involvement and surgical management remains limited. Methods: Using PubMed, studies published prior to November 2018 with the keywords “RA, etiology”; “RA, spine management”; “RA, surgical management”; “RA, treatment”; “RA, DMARDs”; “RA, lumbar spine”; “RA, spine surgical outcomes”; “RA, imaging” were evaluated. Results: The narrative review addresses the epidemiology, manifestations, imaging, surgical complications, and operative and nonoperative management of RA involvement of the lumbar spine. Conclusions: Rheumatoid involvement of the lumbar spine can present with lower back pain, neurogenic claudication, radiculopathy, spinal deformity, and instability. Patients with RA have significantly higher rates of vertebral fractures and complications following surgical intervention. However, in the setting of instability and spinal deformity, thoughtful surgical planning in conjunction with optimal medical management is recommended.

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Laminectomy

Techy¹,

Bell²

2012

Perioperative Management of Patients With Rheumatic Disease

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Atteinte radiologique du rachis lombaire au cours de la polyarthrite rhumatoïde

Cited by 7 publications

References 16 publications

The Pitfalls in Surgical Management of Lumbar Canal Stenosis Associated With Rheumatoid Arthritis

The Pitfalls in Surgical Management of Lumbar Canal Stenosis Associated With Rheumatoid Arthritis

Surgical Management of the Lumbar Spine in Rheumatoid Arthritis

Laminectomy

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