Journal List > J Korean Rheum Assoc > v.15(4) > 1003637

Park and Park: Spinal Diseases and Surgery in Rheumatoid Disorders

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.

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Fig. 1.
Unilateral facet arthritis of atlanto-axial joint in RA patient.
jkra-15-285f1.tif
Fig. 2.
환축추 아탈구(Atlanto-axial subluxation) (2).
jkra-15-285f2.tif
Fig. 3.
Atlanto-axial impaction (2).
jkra-15-285f3.tif
Fig. 4.
Subaxial subluxation (2).
jkra-15-285f4.tif
Fig. 5.
Multiple osteoporotic compression fracture.
jkra-15-285f5.tif
Fig. 6.
Osteonecrosis of vertebral body (Kum-mell's disease) (A) simple lateral view (B) MRI.
jkra-15-285f6.tif
Fig. 7.
Vertebroplasty for severe osteoporotic compression fracture.
jkra-15-285f7.tif
Fig. 8.
Severe canal stenosis due to cement leakage after vertebroplasty.
jkra-15-285f8.tif
Fig. 9.
Junctional fracture after kyphoplasty.
jkra-15-285f9.tif
Fig. 10.
Posterior fusion.
jkra-15-285f10.tif
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.
jkra-15-285f11.tif
Fig. 12.
Anterior fusion for osteoporotic burst fracture in RA patient. (A) preoperation, (B) MRI, (C) postoperation.
jkra-15-285f12.tif
Fig. 13.
(A) 3D CT-image of the spondylo-discitis patient, (B) axial image of CT in spondylo-discitis site.
jkra-15-285f13.tif
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.
jkra-15-285f14.tif
Fig. 15.
Diffuse idiopathic skeletal hyperostosis. (A) preoperation, (B) compression myelopathy at posterior aspect in thoracic spine, (C) postoperation: decompression and instrumentation.
jkra-15-285f15.tif
Table 1.
Algorithm of the treatment in RA patient (13).
jkra-15-285f16.tif
Table 2.
Algorithm of treatment in osteoporotic compression fracture (13)
jkra-15-285f17.tif
Table 3.
Algorithm of treatment in ankylosing spondylitis (13).
jkra-15-285f18.tif
Table 4.
Algorithm of treatment in diffuse idiopathic skeletal hyperostosis (13).
jkra-15-285f19.tif
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