The Condition: Rheumatoid Arthritis
Rheumatoid arthritis is an auto-immune disease which is manifested in several parts of the body. Most patients suffer from cervical spine symptoms such as inflammatory process that may affect ligaments, bones, and joints of the cervical spine.
Symptoms
Occipital neuralgia or pain in the neck, the area of ears or in base of the head is one of the common complaints. Difficulty in neck motion, and a sensation of falling of the head may be next. Some feelings of shock-like sensations may radiate into other body parts such as the extremities. The passage of time may bring worsened spinal cord condition which is demonstrated in weakness of the neck and the hands, and ultimately brain stem effect called myelopathy.
Diagnose
- X-rays: x-ray of the cervical spine can give a reasonably reliable picture of bone alignment As well as possible Osteopenia (bone loss).
- MRI: This is a useful tool to show the status of the brainstem and the spinal cord.
- The most important function of imaging is giving an indication regarding the degree of neurological damage to the patient, all the way to paralysis and even death.
Treatment: Non-Surgical
The main purpose of non-surgical treatment is preventing development of irreversible neurologic damage and alleviating pain. Some alternatives are –
- Physical therapy
- Medication
- Constant medical exams and monitoring
- Patient education sessions
- Soft collars
Surgery: Cervical Laminectomy
- Cervical laminectomy includes either a partial or a complete discectomy.
- The surgery includes fusion of bone graft that helps healing and re-growth of bone – autograft means using the patient bone and allograft is using a donor’s bone.
- Some surgeries include instrumentation which means using medical devices such as rods, plates or pedicle screws, which help to establish spinal stabilization and prevent any micro motion that may delay successful fusion.