title: Correlation between severity of rheumatoid arthritis and manner and extent of cervical lesion.
abstract: Abstract To determine the proper management of treatment for rheumatoid cervical lesions, we investigated the clinical course of the cervical spine in rheumatoid arthritis (RA). The severity of RA was classified into three groups according to the disease subsets advocated by Ochi et al.: the less erosive subset (LES), the more erosive subset (MES), and mutilating disease (MUD). Then the following radiographic assessments were performed on cervical roentogenograms: atlantoaxial subluxation (AAS), vertical subluxation (VS), and subaxial subluxation (SAS). One hundred and seventy-four patients were available for this study. The mean age of the patients was 60.9 years (19-85 years). The average duration from the onset of RA was 19.1 years (10-40 years). Eighty-seven patients were classified as LES, 69 were MES, and 18 were MUD. We found that few patients in the LES group had required an operation on the cervical spine. AAS was seen in about 60% of the MES patients, but few cases had VS or SAS, and most operations were atlantoaxial fusion. All patients in the MUD group had some cervical instabilities. Not only VS but also SAS were seen in more than half of these patients, and many patients had required occipitothoracic fusion.
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University School of Medicine , 5 Zaifu-cho, Hirosaki 036-8562 , Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mitsuka
authors.forename: Takao
authors.initials: T
authors.lastname: Miura
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Ueyama
authors.forename: Akio
authors.initials: A
authors.lastname: Sannohe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Toh