What causes cervical spine instability in rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Cervical spine instability may be observed in patients with established RA who have degeneration of the ligaments and bone in the C-spine area. Degeneration of the transverse ligament can lead to instability at the C1-C2 level. Minor trauma can lead to neurologic sequelae due to inherent instability.

Exercise caution in evaluating RA patients after minor falls, motor vehicle accidents, or other injuries. Cervical spine injury may occur spontaneously. Patients with long-standing disease may need careful evaluation perioperatively to detect any cervical spine instability before neck manipulation or intubation during surgery. Patients with RA of the cervical spine who have refractory pain, clearly evident neurologic compromise, or intrinsic spinal cord signal changes on magnetic resonance imaging (MRI) are generally candidates for surgical intervention.

For more information on these topics, see Hand and Wrist Surgery in Rheumatoid Arthritis and Rheumatoid Arthritis of the Cervical Spine.

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