Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery

Na, Min-Kyun; Chun, Hyoung-Joon; Bak, Koang-Hum; Yi, Hyeong-Joong; Ryu, Je Il; Han, Myung-Hoon

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자료유형: 학술저널

저자정보: Na, Min-Kyun (Department of Neurosurgery, Hanyang University Medical Center) Chun, Hyoung-Joon (Department of Neurosurgery, Hanyang University Medical Center) Bak, Koang-Hum (Department of Neurosurgery, Hanyang University Medical Center) Yi, Hyeong-Joong (Department of Neurosurgery, Hanyang University Medical Center) Ryu, Je Il (Department of Neurosurgery, Hanyang University Guri Hospital) Han, Myung-Hoon (Department of Neurosurgery, Hanyang University Guri Hospital)

저널정보: 대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제59권 제6호

발행연도: 2016.1

수록면: 590 - 596 (7page)

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Objective : Rheumatoid arthritis (RA) is a systemic disease that can affect the cervical spine, especially the atlantoaxial region. The present study evaluated the risk factors for atlantoaxial subluxation (AAS) development and progression in patients who have undergone surgical treatment. Methods : We retrospectively analyzed the data of 62 patients with RA and surgically treated AAS between 2002 and 2015. Additionally, we identified 62 patients as controls using propensity score matching of sex and age among 12667 RA patients from a rheumatology registry between 2007 and 2015. We extracted patient data, including sex, age at diagnosis, age at surgery, disease duration, radiographic hand joint changes, and history of methotrexate use, and laboratory data, including presence of rheumatoid factor and the C-reactive protein (CRP) level. Results : The mean patient age at diagnosis was 38.0 years. The mean time interval between RA diagnosis and AAS surgery was $13.6{\pm}7.0$ years. The risk factors for surgically treated AAS development were the serum CRP level (p=0.005) and radiographic hand joint erosion (p=0.009). The risk factors for AAS progression were a short time interval between RA diagnosis and radiographic hand joint erosion (p<0.001) and young age at RA diagnosis (p=0.04). Conclusion : The CRP level at RA diagnosis and a short time interval between RA diagnosis and radiographic hand joint erosion might be risk factors for surgically treated AAS development in RA patients. Additionally, a short time interval between RA diagnosis and radiographic hand joint erosion and young age at RA diagnosis might be risk factors for AAS progression.

#Atlantoaxial subluxation #Rheumatoid arthritis #Posterior cervical fusion

참고문헌 (26)

참고문헌 신청

Ahn JK / 2011 / Risk factors for development and progression of atlantoaxial subluxation in Korean patients with rheumatoid arthritis / Rheumatol Int 31:1363~1368

Alamanos Y / 2005 / Epidemiology of adult rheumatoid arthritis / Autoimmun Rev 4:130~136

Arnett FC / 1988 / The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis / Arthritis Rheum 31:315~324

Blom M / 2013 / Long-term follow-up of the cervical spine with conventional radiographs in patients with rheumatoid arthritis / Scand J Rheumatol 42:281~288

Casey AT / 1996 / Surgery on the rheumatoid cervical spine for the non-ambulant myelopathic patient-too much, too late? / Lancet 347:1004~1007

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