Abstract
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease affecting a significant percentage of the population. The cervical spine is often affected in this disease and can present in the form of atlantoaxial subluxation, vertical subluxation or cranial settling, or subaxial subluxation. The thoracic and lumbar spine may also be affected, but these instances are more sporadic. Patients may present with symptoms and disability secondary to these entities but may also be neurologically intact. Spinal involvement in RA can pose a challenge to the clinician, and the appropriate role of surgical intervention is controversial. The goal of this chapter is to outline the pathology, pathophysiology, and clinical presentation of and radiographic findings in the rheumatoid spine. Additionally, surgical indications and approaches will be discussed in depth. By the conclusion of the chapter, the reader should be able to clearly understand the ways in which RA affects the cervical, thoracic, and lumbar spine. Moreover, this chapter aims to clearly demonstrate surgical indications in the rheumatoid spine and highlight the numerous treatment options available to these patients.
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