Involvement of the cervical spine in rheumatoid arthritis

Halla, James T.; Hardin, Joe G.; Vitek, Jiri J.; Alarcón, Graciela S.

doi:10.1002/anr.1780320522

Cited by 81 publications

(47 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cervical spine disorders are common consequences of severe rheumatoid arthritis (RA) (1). The most common characteristics of the cervical spine disorders in RA are horizontal and vertical subluxations of the atlantoaxial joint, i.e., anterior atlantoaxial subluxation (aAAS) and atlantoaxial impaction (AAI) (2).…”

mentioning

confidence: 99%

Early and extensive erosiveness in peripheral joints predicts atlantoaxial subluxations in patients with rheumatoid arthritis

Neva¹,

Isomäki²,

Hannonen³

et al. 2003

Arthritis & Rheumatism

View full text Add to dashboard Cite

Objective. To study the prevalence of cervical spine subluxations and predictive factors for atlantoaxial subluxations (including anterior atlantoaxial subluxation and atlantoaxial impaction, i.e., vertical subluxation) in patients with rheumatoid arthritis (RA) who were treated early and continuously with diseasemodifying antirheumatic drugs for 8-13 years.Methods. Radiographs of the cervical spine were obtained in 103 of 110 patients (the 110 surviving patients of the original 135-patient cohort) at their 8-13-year followup visits. The prevalence of cervical spine subluxations was determined. Demographic variables and the first 5-year serial data concerning disease course were analyzed in a logistic regression model to find predictive factors for atlantoaxial subluxations.Results. Atlantoaxial subluxations were found in 14 patients (14%), and 5 patients (5%) had subaxial subluxations. Older age at baseline, greater disease activity during the first 5 years, and early erosiveness in peripheral joints predicted the development of atlantoaxial subluxations. Patients who had >10% of the maximum possible radiographic damage (by Larsen score) in peripheral joints at 5 years were 15.9 times more likely to develop atlantoaxial subluxations at 8-13 years than patients whose peripheral joint damage remained <10% of the maximum.Conclusion. Compared with historical control RA cohorts, a lower prevalence of cervical spine destruction was found in the present group of patients. Rapid erosiveness in peripheral joints was the best predictor for atlantoaxial subluxations. Extensive erosiveness in peripheral joints should alert rheumatologists to the possible development of atlantoaxial subluxations in patients with RA.

show abstract

mentioning

confidence: 99%

Early and extensive erosiveness in peripheral joints predicts atlantoaxial subluxations in patients with rheumatoid arthritis

Neva¹,

Isomäki²,

Hannonen³

et al. 2003

Arthritis & Rheumatism

View full text Add to dashboard Cite

show abstract

“…This practice is supported by the presumed prevalence of cervical instability in these patients [3][4][5][6][7] as well as by the findings of Collins et al, who reported an abnormal anterior atlantodental interval and subaxial subluxation in fifty-five (49%) and twenty-four (21%) of 113 patients, respectively, who were undergoing total joint arthroplasty 12 . Nevertheless, Boden et al found that the posterior atlantodental interval and the space available for the cord were much better predictors of neurologic compromise than were the anterior atlantodental interval and subaxial subluxation 9 .…”

Section: Methodsmentioning

confidence: 90%

“…Such cervical spine involvement occurs relatively early in the course of rheumatoid arthritis, and most patients demonstrate radiographic changes in the cervical spine within the first few years after diagnosis 2,3 . Three characteristic patterns of instability have been described: atlantoaxial subluxation, cranial settling (also known as basilar invagination), and subaxial subluxation [3][4][5][6][7] . Although previous authors have reported that an abnormal anterior atlantodental interval is indicative of upper cervical instability 8 , more recent studies have suggested that this finding correlates poorly with the risk of neurologic deterioration 9,10 .…”

mentioning

confidence: 99%

Predictors of Paralysis in the Rheumatoid Cervical Spine in Patients Undergoing Total Joint Arthroplasty

Grauer

Tingstad²,

Rand

et al. 2004

The Journal of Bone and Joint Surgery-American Volume

View full text Add to dashboard Cite

“…Complications of the cervical spine are common in patients with rheumatoid arthritis (RA) often resulting in anatomical deformities, particularly those of the upper cervical spine [1]. Both clinical and radiological signs of rheumatoid changes of the cervical spine are present in up to 86% of all RA patients [2,3].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine

et al. 2013

View full text Add to dashboard Cite

show abstract

Involvement of the cervical spine in rheumatoid arthritis

Cited by 81 publications

References 42 publications

Early and extensive erosiveness in peripheral joints predicts atlantoaxial subluxations in patients with rheumatoid arthritis

Early and extensive erosiveness in peripheral joints predicts atlantoaxial subluxations in patients with rheumatoid arthritis

Predictors of Paralysis in the Rheumatoid Cervical Spine in Patients Undergoing Total Joint Arthroplasty

Evaluation of clinical results and quality of life after surgical reconstruction for rheumatoid cervical spine

Contact Info

Product

Resources

About