Subaxial Subluxation (SAS) and Cervical Deformity in Patients with Rheumatoid Arthritis in Relation to Selected Sagittal Balance Parameters

TL;DR

This paper explores how sagittal balance parameters relate to cervical spine instability in rheumatoid arthritis patients.

Contribution

It identifies a novel biomechanical relationship between specific cervical parameters and long-term disease progression.

Findings

A statistical relationship was found between C4 and C5 distance and the OI parameter.

The OI parameter remains constant throughout life in patients with over 20 years of disease duration.

Biomechanical factors may contribute to cervical instability in rheumatoid arthritis patients.

Abstract

Introduction: Synovitis and damage to natural stabilizers of many axial and peripheral joints make patients with rheumatoid arthritis particularly susceptible to sagittal balance disorders of the axial skeleton. This may determine the high individual variability of cervical spine deformities as well as differences in the rate of development of disease symptoms in these patients, such as radiculopathy and myelopathy. Methods: In the scientific literature, in addition to systemic factors, more and more attention is paid to work on biomechanical factors in the development of cervical spine instability. One of the methods for assessing the influence of biomechanical factors, which can also be used in everyday practice, is the analysis of radiological parameters of sagittal balance. Results: Among the selected sagittal balance parameters studied, a statistical relationship between C4 and C5 distance and the OI parameter has been found, indicating a relationship to a parameter that remains constant throughout an individual’s life in the group of patients with disease duration over 20 years. Conclusions: The development of instability and deformity in the subaxial segment of the cervical spine in patients with rheumatoid arthritis may be the result of insufficiently understood components of biomechanical factors; hence, further research in this field is necessary.

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