Miscellaneous Cervical Spine Problems

Abstract

The most common inflammatory processes leading to cervical spine instability are the collagen vascular diseases (1, 2), primarily rheumatoid arthritis. These conditions lead to ligament instability, which most often, as far as the cervical spine is concerned, involves the upper and lower portions of the spine. Initially the apophyseal joints are involved, with the joint space first becoming indistinct and then obliterated (Fig. 6.1A). Later, as the disease process progresses, fusion of the apophyseal joints and indeed, the posterior elements of the cervical vertebra, can occur (Fig. 6.1B). This is most likely to occur with Still’s disease, the most aggressive form of rheumatoid arthritis. In the upper cervical spine, atlantoaxial instability also can be seen and results in marked displacement of Cl on C2 (Fig. 6.1C).