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- Title
Surgical management of cervical spine instability in rheumatoid arthritis patients.
- Authors
Marques, P. M.; Cacho-Rodrigues, P.; Negrão, P.; Pinto, R.; Ribeiro-Silva, M.; Neves, N.; Linhares, D.
- Abstract
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 atlantoa xial (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 SAI. 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.
- Subjects
PORTUGAL; CERVICAL vertebrae; RHEUMATOID arthritis; SPINAL instability; NEUROLOGIC manifestations of general diseases; RHEUMATOID arthritis treatment; RESEARCH; THERAPEUTICS; SURGERY; PATIENTS
- Publication
Acta Reumatológica Portuguesa, 2015, Vol 40, Issue 1, p34
- ISSN
0303-464X
- Publication type
Article