Investigators of this study found predictors for severe cervical spine instability in patients with rheumatoid arthritis included mutilating changes, corticosteroid treatment and previous joint surgery.
Researchers identified 503 outpatients with rheumatoid arthritis who fit the American Rheumatism Association and American College of Rheumatology criteria for the disease and did not have severe cervical spine instability at baseline. Of these patients, 143 patients had more than 10-year follow-up (mean of 11.4 years) and 223 patients had more than 5-year follow-up (mean of 9.5 years). Investigators determined predictors of severe cervical instability which researchers defined as an atlantodental interval of at least 10 mm, a Ranawat value of no more than 10 mm and subaxial subluxation at multiple levels or of 4 mm or more.
Results showed that in both cohorts, the incidence of cervical spine instability and severe cervical spine instability increased significantly during the more than 10-year follow-up. With multivariable proportional hazards models, investigators found severe instability predictors included baseline mutilating changes, corticosteroid administration and previous joint surgery. - by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.