Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis

Siempis, Timoleon; Tsakiris, Charalampos; Anastasia, Zikou K; Alexiou, George Α.; Voulgaris, Spyridon; Argyropoulou, Maria I.

doi:10.1007/s00296-022-05239-5

Cited by 3 publications

(1 citation statement)

References 104 publications

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“…The study involved patients with a long-term course of the disease, on average 21 years (from 2 to 50), who were consulted in the years 2019-2022 at the NIGR & R Clinics in terms of qualification for surgical treatment of instability. Due to the long-term medical history, regardless of the symptoms, the patients had periodic X-ray examinations of the cervical region, in accordance with the recommendations for the care of patients with RA [20][21][22]. The criterium for inclusion in the current study was the diagnosis of AAS or SAS instability in these patients.…”

Section: Methodsmentioning

confidence: 99%

Relationship between Cervical Instability in the Course of Rheumatoid Arthritis and Pelvic Parameters of Sagittal Balance

Wróblewski,

Koszela,

Mańczak

et al. 2023

JCM

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Background: The aim of the study is to search for a relationship between cervical instability in the course of rheumatoid arthritis (RA) and pelvic parameters of sagittal balance and lumbar lordosis (LL). Methods: The study included 47 patients with rheumatoid arthritis with instability of the cervical segment, who were referred for a consultation to assess indications for surgical treatment. The patients underwent a radiological functional examination of the cervical region and postural examination of the entire spine. The basic parameters of the lumbar section and pelvis of these patients were compared with the population values. Then, using statistical methods, the correlation between radiological parameters of various types of instability and lumbar lordosis (LL), pelvic parameters (PI, SS, PT), as well as the patient’s age and duration of the disease was assessed. Results: A statistical correlation was found between the instability in the cervical spine C2–C3 level and the value of the PT and PI angles. A statistically significant correlation was discovered between C1–C2 instability and younger patient age. There was no significant difference in the values of the pelvic parameters and lumbar lordosis in patients with rheumatoid arthritis compared to the population values. Conclusions: Preliminary results suggest that there is a relationship between selected pelvic parameters and the development of instability in patients with rheumatoid arthritis. This may be important in planning treatment and assessing disease progression. Further studies on a larger group of patients are needed, as well as studies evaluating the correlation between other sagittal balance parameters and cervical instability in patients with RA.

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Section: Methodsmentioning

confidence: 99%

Relationship between Cervical Instability in the Course of Rheumatoid Arthritis and Pelvic Parameters of Sagittal Balance

Wróblewski,

Koszela,

Mańczak

et al. 2023

JCM

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Emergencies in inflammatory rheumatic diseases

Auyezkhankyzy,

Izekenova,

Kocyigit

2024

Rheumatol Int

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Inflammatory rheumatic diseases (IRDs), encompassing a broad spectrum of chronic disorders, typically necessitate prolonged therapeutic intervention. Nevertheless, these diseases can sometimes manifest as severe emergencies requiring prompt and extensive medical intervention. Urgent intervention is essential for effectively recognizing and managing these situations, as they have the potential to be life-threatening and can result in severe morbidity and mortality. Emergencies in IRDs can occur with different frequencies and manifestations, including nervous system issues, severe infections, thrombosis-emboli, renal crises, gastrointestinal issues, and cardiovascular events. The fact that these events can occur across different IRDs underscores the necessity for heightened awareness and readiness among healthcare professionals. The pathophysiologic mechanisms that cause rheumatic emergencies are complex and involve multiple factors. These emergencies frequently arise due to the interplay between the inflammatory characteristics of rheumatic diseases and different systemic triggers. Early detection and treatment can have a substantial impact on an individual’s prognosis in cases of severe and life-threatening disorders that require prompt recognition. Rapid decision-making and urgent care are required to effectively address rheumatic emergencies, as well as the implementation of a diagnostic flowchart. This article provides an overview of the emergencies linked to IRDs, classifying and assessing them individually. This article aims to enhance healthcare professionals’ knowledge and awareness of critical situations by examining current recommendations and pathophysiological information. Implementing standardized diagnostic and treatment methods, providing patient education, and conducting continuing research into the underlying mechanisms are essential for enhancing the management of these critical situations and improving patient outcomes.

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Atlantoaxial Instability in the Course of Rheumatoid Arthritis in Relation to Selected Parameters of Sagittal Balance

Wróblewski,

Mańczak,

Gasik

2024

JCM

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Background: Atlantoaxial instability is the most common cervical instability in patients with rheumatoid arthritis (RA). Its course may differ in different patients and may have different degrees of severity and symptoms. Methods: There are a number of studies on systemic factors associated with the development of this instability, but there are few publications in the scientific literature on the influence of biomechanical factors on the development of cervical instability. One of the areas that allows the study of biomechanical factors influencing spine pathologies is the analysis of sagittal balance using radiological parameters. The study of radiological parameters of sagittal balance has contributed to understanding the pathology of selected spine diseases and is currently an indispensable tool in planning surgical treatment. Results: The presented study, conducted on a group of RA patients with cervical instability, was performed to look for a relationship between C1–C2 instability and sagittal balance parameters. Conclusions: Among the examined selected parameters, a statistically relationship between C1–C2 instability and the Cobb angle C1–C7 and OD-HA parameters has been found. This confirms the need for further in-depth research on this areas.

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Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis

Cited by 3 publications

References 104 publications

Relationship between Cervical Instability in the Course of Rheumatoid Arthritis and Pelvic Parameters of Sagittal Balance

Relationship between Cervical Instability in the Course of Rheumatoid Arthritis and Pelvic Parameters of Sagittal Balance

Emergencies in inflammatory rheumatic diseases

Atlantoaxial Instability in the Course of Rheumatoid Arthritis in Relation to Selected Parameters of Sagittal Balance

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