NENORACo Study: Cervical spine involvement in rheumatoid arthritis patients

should be very rare! This says a new study from Helsinki University. Patients were treated with infliximab or placebo.

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Nevertheless, many elderly patients, such as Liz, have a cervical spine involvement. The rheumatic instability of the cervical spine can be divided into three stages.
Stage I: Horizontal instability between C1st and C2 Cervical vertebrae (atlantoaxial subluxation)
Stage II: The cervical spine shows a relative elevation of the dens relative to the head. This leads to a narrowing of the exit point for the spinal cord at the base of the skull (foramen magnum).
Stage III: Due to the mechanical overloading are the individual cervical vertebrae called ”staircase phenomenon on the cervical spine”. The instability affects now the entire cervical spine (subaxial subluxation).

The development of spinal cord injury (cervical myelopathy) are possible at any stage of RA. Often a surgical treatment is necessary.