Cervical spine involvement in Rheumatic Arthritis (RA) can pose a challenge to the clinician and the appropriate role of surgical intervention is controversial. The cervical spine is often affected by this disease and can present in the form of atlanto axial instability (AAI), cranial settling (CS), or subaxial subluxation (SAS). Patients may present with symptoms and disability secondary to these entities but may also be neurologically intact.
The current article focuses on the involvement of rheumatoid arthritis in the cervical spine in order to provide a better understanding of the indications and options for surgery. Cervical spine involvement in patients with RA suggests that chronic inflammation of the cervical spine initially leads to a proliferation of fibrovascular tissue and pannus formation resulting in bony erosion and ligamentous laxity. This cascade can lead to cervical…
