J Korean Rheum Assoc.  2008 Dec;15(4):285-295. 10.4078/jkra.2008.15.4.285.

Spinal Diseases and Surgery in Rheumatoid Disorders

Affiliations
  • 1Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, Kyunggi-do, Korea. hyparkys@hanyang.ac.kr

Abstract

Rheumatoid disorders are chronic multi-systemic diseases of unknown cause. The characteristic feature is persistent inflammatory synovitis usually involving peripheral joints in a symmetrical distribution. Features of spinal involvement in rheumatoid disorders include erosive synovitis, ligamentous subluxation, osteopenia, and vertebral-body fractures. In this article, authors describe common spinal disorders in rheumatoid diseases and also spinal surgery.

Keyword

Rheumatoid disorders; Spinal surgery

Figure

  • Fig. 1. Unilateral facet arthritis of atlanto-axial joint in RA patient.

  • Fig. 2. 환축추 아탈구(Atlanto-axial subluxation) (2).

  • Fig. 3. Atlanto-axial impaction (2).

  • Fig. 4. Subaxial subluxation (2).

  • Fig. 5. Multiple osteoporotic compression fracture.

  • Fig. 6. Osteonecrosis of vertebral body (Kum-mell's disease) (A) simple lateral view (B) MRI.

  • Fig. 7. Vertebroplasty for severe osteoporotic compression fracture.

  • Fig. 8. Severe canal stenosis due to cement leakage after vertebroplasty.

  • Fig. 9. Junctional fracture after kyphoplasty.

  • Fig. 10. Posterior fusion.

  • Fig. 11. Pull-out of pedicle screw after posterior fusion in the patient with combined disease – RA, spinal stenosis, osteoporosis. (A) preoperation, (B) postoperation, (C) follow-up.

  • Fig. 12. Anterior fusion for osteoporotic burst fracture in RA patient. (A) preoperation, (B) MRI, (C) postoperation.

  • Fig. 13. (A) 3D CT-image of the spondylo-discitis patient, (B) axial image of CT in spondylo-discitis site.

  • Fig. 14. Pedicle subtraction osteotomy and anterior interbody fusion in ankylosing spondylitis with spondylo-discitis patient. (A) preoperation: coronal and sagittal decompensation, (B) pos-toperation: correction of decompensation.

  • Fig. 15. Diffuse idiopathic skeletal hyperostosis. (A) preoperation, (B) compression myelopathy at posterior aspect in thoracic spine, (C) postoperation: decompression and instrumentation.


Reference

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