Predictive Risk Factors of Cervical Spine Instabilities in Rheumatoid Arthritis

Terashima, Yoshiki; Yurube, Takashi; Harai, Hiroaki; Sugiyama, Daisuke; Sumi, Masatoshi

doi:10.1097/brs.0000000000001853

Cited by 41 publications

(37 citation statements)

References 45 publications

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“…Terashima et al . 's research, a prospective over 10‐year cohort study, further demonstrates that long‐term corticosteroid administration is a relatively strong indicator of poor prognosis in RA patients with CSI . This may be explained in that corticosteroid is a double‐edged sword, although it can reduce the disease activity.…”

Section: Discussionmentioning

confidence: 96%

“…One recent prospective study, accomplished by Terashima et al, also showed that established mutilating changes are relatively robust indicators for a poor prognosis of the cervical spine in patients with RA. 37 This will be very instructive to the clinician.…”

Section: Discussionmentioning

confidence: 97%

“…Terashima et al's research, a prospective over 10-year cohort study, further demonstrates that long-term corticosteroid administration is a relatively strong indicator of poor prognosis in RA patients with CSI. 37 This may be explained in that corticosteroid is a double-edged sword, although it can reduce the disease activity. On the one hand, long-term corticosteroid treatment results in bone mineral loss; on the other hand, it directly induces chondrocyte apoptosis and the destruction of bone.…”

Section: Discussionmentioning

confidence: 99%

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Cervical spine involvement risk factors in rheumatoid arthritis: a meta‐analysis

Zhu

Luo

et al. 2017

Int J of Rheum Dis

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Cervical spine involvement risk factors in rheumatoid arthritis: a meta‐analysis

Zhu

Luo

et al. 2017

Int J of Rheum Dis

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“…However, patients with a worse disease activity score, high disease activity and erosive disease at baseline have a high risk of atlantoaxial involvement in early rheumatoid arthritis (ERA) (disease duration < 12 months) [1]. Affection of the small joints of the hand and foot, failure of antirheumatic therapies, intake of glucocorticoids, young age at diagnosis, level of CRP, female sex, and low BMI were identified as risk factors for cervical involvement [21,22].…”

Section: Discussionmentioning

confidence: 99%

Cervical Myelopathy in Patients Suffering from Rheumatoid Arthritis—A Case Series of 9 Patients and A Review of the Literature

Janssen

Nouri

Tessitore

et al. 2020

JCM

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Cervical myelopathy occurs in approximately 2.5% of patients suffering from rheumatoid arthritis (RA) and is associated with notable morbidity and mortality. However, the surgical management of patients affected by cervical involvement in the setting of RA remains challenging and not well studied. To address this, we conducted a retrospective analysis of our clinical database between May 2007 and April 2017, and report on nine patients suffering from cervical myelopathy due to RA. We included patients treated surgically for cervical myelopathy on the basis of diagnosed RA. Clinical findings, treatment and outcome were assessed and reported. In addition, we conducted a narrative review of the literature. Four patients were male. Mean age was 64.8 ± 20.5 years. Underlying cervical pathology was anterior atlantoaxial instability (AAI) associated with retrodental pannus in four cases, anterior atlantoaxial subluxation (AAS) in two cases and basilar invagination in three cases. All patients received surgical treatment via posterior fixation, and in addition two of these cases were combined with a transnasal approach. Preoperative modified Japanese orthopaedic association scale (mJOA) improved from 12 ± 2.4 to 14.6 ± 1.89 at a mean follow-up at 18.8 ± 23.3 months (range 3-60 months) in five patients. In four patients, no follow up was available, and the mJOA of these patients at time of discharge was stable compared to the preoperative score. One patient died two days after surgery, where a pulmonary embolism was assumed to be the cause of mortality, and one patient sustained a temporary worsening of his neurological deficit postoperatively. Surgery is generally an effective treatment method in patients with inflammatory arthropathies of the cervical spine. Given the nature of the RA and potential instability, fixation in addition to cord decompression is generally required.

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“…Patients with RA with confirmed osteopenia or osteoporosis, particularly those with lower BMI appear to be at increased risk of cervical instability [6]. Established mutilating changes, concomitant corticosteroid treatment, and previous joint surgery are relatively robust indicators for a poor prognosis of the cervical spine in patients with RA [7]. Cervical myelopathy manifests itself insidiously, and, once it is established, mortality is a common outcome if the pathology isn't treated [8].…”

mentioning

confidence: 99%

Rheumatoid Arthritis of the Craniovertebral Junction: Surgical Strategies, Current Approach and Proposal of a New Therapeutic Algorithm

Silva¹,

Barros²,

Pereira³

2017

J Rheum Dis Treat

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Predictive Risk Factors of Cervical Spine Instabilities in Rheumatoid Arthritis

Abstract: 3.

Cited by 41 publications

References 45 publications

Cervical spine involvement risk factors in rheumatoid arthritis: a meta‐analysis

Cervical spine involvement risk factors in rheumatoid arthritis: a meta‐analysis

Cervical Myelopathy in Patients Suffering from Rheumatoid Arthritis—A Case Series of 9 Patients and A Review of the Literature

Rheumatoid Arthritis of the Craniovertebral Junction: Surgical Strategies, Current Approach and Proposal of a New Therapeutic Algorithm

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