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Rheumatoid Arthritis

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Reconstruction of Upper Cervical Spine and Craniovertebral Junction

Abstract

Substantial amount of patients treated because of upper cervical spine (UCS) and craniovertebral junction (CVJ) instability and/or deformity are those who suffer from rheumatoid arthritis (RA). Conversely, up to 86% of patients suffering from RA have cervical spine involvement with most of them involving the upper cervical region and CVJ. The prognosis of conservatively treated patients with marked atlantoaxial (AA) instability and/or cranial settling is generally poor, especially if neurologic deficit is present. Early surgery that reduces the deformity, stabilizes the spine, and decompresses neural structures can lead to pannus resorption, prevent the odontoid basilar impression and thus improve patient’s prognosis. Expectant care until myelopathy develops carries a worse prognosis in RA patients.

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Authors and Affiliations

  1. Department of Neurosurgery, Neurocenter, Regional Hospital Liberec, Husova St. 10, 46063, Liberec, Czech Republic

    P. Suchomel & P. Buchvald

  2. Department of Neurosurgery, University of Cincinnati, Medical Center, Albert Sabin Way 231, Cincinnati, OH, 45267-0515, USA

    O. Choutka

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Suchomel, P., Buchvald, P., Choutka, O. (2011). Rheumatoid Arthritis. In: Reconstruction of Upper Cervical Spine and Craniovertebral Junction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-13158-5_18

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