Surgical management of cervical spine instability in rheumatoid arthritis patients

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Marques, PM (Author) Other; Cacho Rodrigues, P (Author) Other; Ribeiro Silva, M (Author) Other; Linhares, D (Author) Other; Negrao, P (Author) Other; Pinto, R (Author) Other; Neves, N (Author) FMUP

Journal

Title: Acta Reumatologica Portuguesa

Vol. 40

Pages: 34-39

ISSN: 0303-464X

Publisher: Sociedade Portuguesa de Reumatologia

Indexing

ISI Web of Knowledge - 3 Citations

Scopus - 3 Citations

Other information

Authenticus ID: P-00G-57Z

Abstract (EN): Aim: Cross-sectional study that aims to evaluate the results of cervical spine surgeries due to rheumatoid arthritis (RA) instability, between January of 2000 and of 2012 in a main Portuguese centre. Methods: Patients followed on Rheumatology department submitted to cervical spine fusion due to atlantoaxial (AAI), sub-axial (SAI) or cranio-cervical (CCI) instabilities between 2000-2012 were included. Information about the surgical procedure and associated complications was gathered. Imagiologic and clinical indexes before and after surgery (as anterior and posterior atlanto-axial interval and Ranawat index) were evaluated and compared using adequate statistics. Results: Forty-five patients with RA were included: 25 with AAI, 13 with CCI and 7 with SAT. Ten AAI and 4 CCI patients were submitted to wiring stabilization techniques; 15 AAI and 9 CCI patients to rigid ones; and in all patients with SAI an anterior cervical arthrodesis was chosen. There is a significant increase in PADI and a decrease in AADI in the postoperative evaluation (p<0,05) that only remains significant when rigid systems were used. After surgery the Ranawat index decreased (p<0,05) and no patient showed a deterioration of neurological condition. The complication rate was of 23,1%, with 5 mal-unions. Conclusion: Surgical management of cervical column instabilities in patients with rheumatoid arthritis is a relatively safe procedure, with a high rate of neurologic improvement. Rigid techniques seem to lead to a better imagiological improvement when compared to wiring ones.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6