Health Questions and Answers

Question: How does RA commonly affect the spine?

Answer:

The thoracic and lumbar spines are rarely if ever involved with RA. The cervical spine is commonly involved and deserves special mention. Cervical spine involvement usually is heralded by pain with motion and occipital headache. Significant laxity at the alantoaxial joint with subluxation makes patients prone to slowly progressive, spastic quadriparesis. If this laxity is present, the hyperextension of the neck that occurs during intubation for general anesthesia can produce quadriplegia. Thus patients with neck pain or long-standing disease should undergo cervical spine evaluation before any surgical procedure.

Reference: Harris ED, Budd RC, Firestein GS, et al (eds): Kelley’s Textbook of Rheumatology, 7th ed. Philadelphia, W.B. Saunders, 2005.

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