Risk of Cervical Myelopathy in Rheumatoid Arthritis patients A cross-sectional study

Abstract

ervical spine involvement in RA has long been recognized. Varying degrees of prevalence have been reported as reflected in the literature search. This can be explained by numerous factors, such as differences in sample size, disease duration, follow-up period, medications used, and radiological criteria. Our study was carried out on 40 RA patients complaining of cervical spine pain. 28 (70%) patients had abnormality in cervical spine MRI where odontoid erosions was found in 6 (15%) patients, soft tissue thickening (synovial thickening/effusion) in 27 (67.5%), central atlanto-axial marrow edema was seen in 2 (5%) patients, and atlanto-occipital (subaxial) marrow edema was seen in 2 (5%) patients and no patients had AAS, subaxial sublaxation or brain stem compression. Severity of neurological compromise has been assessed according to the Ranawat Classification of rheumatoid myelopathy, we found that there were 28 (70%) patients in class I, 12 (30%) patients in class II, and no (0%) patients in class III & IV. In RA patients with symptomatic cervical spine involvement, the development of neurological dysfunction related significantly with the presence soft tissue thickening in cervical spine MRI. In patients with erosive peripheral disease it is very probable to also have some changes in Cervical spine.