Spine Surgery for Rheumatoid Arthritis.
Edited By: Jens R. Chapman, M.D.
Last updated Wednesday, December 29, 2004
Review of the conditionWhat are some general characteristics of rheumatoid arthritis of the spine? What are its usual manifestations? As with any joint in the body, the small joints of the spine can be
destroyed by rheumatoid arthritis. This can lead to instability, pain
and in advanced cases to compression of the spinal cord and nerve roots
emerging from it. This occurs most commonly in the upper neck, but may
affect the lower neck or lower back as well.How common is rheumatoid arthritis of the spine (statistics, demographics, risk factors)? One in five to one in three patients with RA have spinal involvement.How is rheumatoid arthritis of the spine diagnosed? What tests or exams may be used? Aside from a physical examination, which includes assessment of the
patient’s neurologic function, radiographs (X-rays) are obtained. These
usually include neck X-rays in which the patient is first asked to bend
their head forward, then backward. Obviously, if the patient has
symptoms in other areas of the spine, X-rays of other areas of the
spine may have to be obtained as well. If these X-rays show reason for
concern an MRI scan will usually be ordered next. Sometimes, a CAT scan
(CT) or Bone-scan may be added.Can medications help rheumatoid arthritis of the spine? In early stages of RA, anti-inflammatory medications can be effective
in decreasing pain and may slow the progression of joint destruction
caused by RA.Can exercises help rheumatoid arthritis of the spine? Once joint destruction of the spine has set in, there are no
specific exercises that can stop or arrest the development of spinal
instability. Maintenance of a normal body posture and a low-impact
exercise program are necessary to avoid severe secondary problems, such
as spontaneous spine fractures and maintain reasonable levels of
cardiopulmonary fitness. Chiropractic manipulation of RA patients with
spinal involvement is, however, clearly contraindicated due to the risk
of causing spinal instability to worsen. Cases of paralysis after spine
manipulation have been reported.
Specifically, how is rheumatoid arthritis of the spine improved by spine surgery for rheumatoid arthritis? Spine surgery can improve the quality of life of an affected RA patient in several major ways:
- By resecting a diseased joint and creating a
permanent bond between the affected vertebrae (in a procedure referred
to as "fusion"), rheumatoid arthritis and its related symptoms are
extinguished from that area.
- Restoration of a normal spinal alignment prevents deterioration of basic vital functions, such as cardiopulmonary fitness.
- Stabilization
and, if necessary, realignment of the spine can protect the patient’s
spinal cord from potentially catastrophic injury.
- Decompression
of compromised nerves can decrease pain, halt progressive loss of nerve
function and may even lead to improved function.
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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