Rheumatoid arthritis of the lumbar spine leading to anterior vertebral subluxation and compression of the cauda equina.
A 71-year-old woman with rheumatoid arthritis suffered a spontaneous anterior subluxation of the fourth lumbar vertebra with compression of the cauda equina. The patient was operated upon with a decompressive lumbar laminectomy and a stabilizing posterior interbody fusion of L4 and L5. Histological examination of the unstable L4-L5 motor segment showed that the apophyseal and discovertebral joints had been destroyed by rheumatoid granulation tissue.
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002420:Cauda Equina; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology*; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D009192:Myelography; D009408:Nerve Compression Syndromes / Q000209:etiology*; D013122:Spinal Diseases / Q000209:etiology*