Predictive Risk Factors of Cervical Spine Instabilities in Rheumatoid Arthritis: A Prospective Multicenter over 10-Year Cohort Study

Hyogo Organization of Spinal Disorders

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Abstract

STUDY DESIGN.: A prospective multicenter >10-year cohort study of outpatients with rheumatoid arthritis (RA). OBJECTIVE.: To identify predictive risk factors of cervical spine instabilities which may induce compression myelopathy in RA patients. SUMMARY OF BACKGROUND DATA.: Many reports described the natural course of cervical spine involvement in RA. However, only a few studies conducted comprehensive evaluation of its prognostic factors. METHODS.: Cervical spine instability was radiographically defined as atlantoaxial subluxation (AAS) with the atlantodental interval (ADI) >3?mm, vertical subluxation (VS) with the Ranawat value 10 years. The Cox proportional hazards regression analysis was performed to determine predictors for the development of “severe” instabilities. To exclude biases from the low follow-up rate, similar assessments were performed in 223 patients followed for >5 years from baseline. RESULTS.: The incidence of cervical spine instabilities and “severe” instabilities significantly increased during >10 years in both 143 and 223 cohorts (all P10-year analysis of two different settings.Level of Evidence: 3

Original languageEnglish
JournalSpine
DOIs
Publication statusAccepted/In press - 2016 Aug 12

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ASJC Scopus subject areas

  • Medicine(all)
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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