Abstract
BackgroundThe aim of this study was to examine the clinical characteristics of rheumatoid arthritis (RA) patients who underwent cervical spine surgery using a multicenter observational database.MethodsWe obtained data from a nationwide observational cohort database of patients with rheumatic diseases (National Database of Rheumatic Diseases by iR-net in Japan (NinJa)) for the fiscal years 2003 to 2011. A total of 39 out of 60 patients who underwent cervical spine surgery for a RA-related cause and whose data were available for two consecutive years (to assess the preoperative patient status) were chosen as cases. Patients with a non-RA-related cause of surgery (e.g., trauma) were excluded. First, we compared the patient characteristics between the cases and total patients in the same fiscal year. Next, 106 eligible controls, who were defined as RA patients enrolled in the same fiscal year as the case subjects, who were matched for age, gender and disease duration (within ±1 year), were selected. We compared the demographic data between the two groups. We also calculated the percentage of patients who underwent cervical spine surgery (surgeries/total number of patients) in fiscal years 2003 to 2011.ResultsAlthough the proportion of patients using biologics linearly increased during study period, the percentage of patients undergoing cervical spine surgeries remained unchanged, at approximately 0.15%. These cases had more tender joints (3 vs. 1, p < 0.01) and exhibited a significantly higher Modified Health Assessment Questionnaire (MHAQ) score (1.13 vs. 0.5, p < 0.01), C-reactive protein (CRP) (1.5 vs. 0.36, p < 0.01), and disease activity score (DAS) 28-CRP (3.63 vs. 2.81, p < 0.01) compared to the controls.ConclusionsOur study revealed that RA patients requiring cervical spine surgery have a higher disease activity (as represented by the DAS28-CRP) and are more functionally disabled (as represented by the MHAQ) than control patients.
Highlights
The aim of this study was to examine the clinical characteristics of rheumatoid arthritis (RA) patients who underwent cervical spine surgery using a multicenter observational database
The collected data consist of two components: patient information over the course of the year [outcome, death, hospitalization, operations, number of total joint arthroplasty procedures in large joints, malignancy and tuberculosis] and information collected on each day that the patient visits the outpatient department of each center [tender-joint count (TJC) and swollen-joint count (SJC), modified health assessment questionnaire (MHAQ) score, Steinbrocker functional classification, patient global and pain visual analog scale scores (PtGVAS, PtPainVAS), the doctor VAS (DrGVAS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, disease activity score (DAS) 28-CRP and the use of corticosteroids, methotrexate (MTX) or biologics]
Patients The data of RA patients who were enrolled in the fiscal years from 2003 to 2011 were employed for the analysis
Summary
The aim of this study was to examine the clinical characteristics of rheumatoid arthritis (RA) patients who underwent cervical spine surgery using a multicenter observational database. Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the synovial joints. RA and patients with osteoarthritis had high proportions of good global scores and satisfaction with their treatment after surgery [7]. It remains unclear whether RA patients undergoing cervical spine surgery differ from those who do not receive surgical treatment in terms of their clinical characteristics and the disease activity of RA. Few studies using a large observational database have examined this issue
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