Spine Surgery for Rheumatoid Arthritis.
Edited By: Jens R. Chapman, M.D.
Last updated Wednesday, December 29, 2004
Considering surgeryWho should consider spine surgery for rheumatoid arthritis for rheumatoid arthritis of the spine and in what cases? RA patients who have unrelenting pain, experience loss of neurologic
function, such as dexterity in hands and feet, or have progressive loss
of spine stability as shown on X-rays should consider such surgery.What happens if nothing is done for rheumatoid arthritis of the spine (best case/worst case scenarios)? The best case scenario includes ocasional neck and back pain
necessitating anti-inflammatory medication use and soft neck collar
with the patient maintaining an active life-style.
A worst case scenario might be sudden death through acute spinal cord compression in an area right below the skull. What options exist for surgery for rheumatoid arthritis of the spine? Stabilization of the spine may be necessary in areas where the
arthritis has led to unacceptable pain and instability. Such a
procedure ("fusion") is nowadays carried out with resection of the
involved joint, placement of a small bone graft taken from the pelvis
into the former joint and stabilization with small titanium screws,
rods and plates.When performed by an experienced surgeon, how effective is spine surgery for rheumatoid arthritis for rheumatoid arthritis of the spine likely to be and how long will the benefit last? Once a solid fusion is obtained, the results are permanent. Eighty-five
per cent of RA patients with fusions report good or excellent relief of
their preoperative symptoms.How urgent is spine surgery for rheumatoid arthritis for rheumatoid arthritis of the spine? Should a spinal cord or nerve compression be manifest, surgical care
should be considered with urgency (within weeks). In absence of
neurologic concerns, a patient with RA can be followed serially with
X-rays and examinations on an annual or semi-annual basis.What are the most frequent and most serious risks of spine surgery for rheumatoid arthritis for rheumatoid arthritis of the spine? How common are they? The most common risks of spine surgery in RA historically were
surgical wound infections and failure of the spinal hardware to provide
adequate stability to the spine. With the advent of modern spinal
instrumentation systems and improved understanding of medical care
needs of RA patients, these occurrences have dramatically decreased.
One in ten patients with a spine fusion performed ten years or more
ago may experience increased pain in their spine due to instability at
a level below a fusion. If this is noticed the previous fusion may have
to be extended to include the newly affected levels. If risks occur during or after spine surgery for rheumatoid arthritis for rheumatoid arthritis of the spine how are they managed? Surgical wound infections or hardware failures may require repeat
surgery. Infections will also require intravenous antibiotics given for
several weeks.Surgery for Rheumatoid arthritis of the spine at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-6293 to make an appointment.
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