Re: RESEARCH - Timing of cervical spine stablization and outcome in patients wit

[Guest guest]

Hi ,

I had C-5,c-6 fused in 1996. I didn't recover well or quickly. it took

3 yrs to get to what i would call normal after the neck surgery. The

DRs say it was because of the fibro. sounds like I was lucky to have

it done before the RA reared its hugly head.I have minimal problems

with my neck now.

Within 2 yrs they did MRIs of my entire spine. several other discs

are deteriorating. Some milder then others. L-5,s-1 doesn't have any

fluid. When I move wrong they push on the spinal cord and then cause

great pain and even lost on motor function some times.

All my DRs agree that surgery should only be done as a last resort

because of the complications of low back surgery and the fibro.

you are talking about cerval stablization and RA. Do you have any

insight on how can RA can affect other spinal surgeries? also, does

this mean I might have more problems with my neck later from the RA.

I know you are not a MD but you are a wealth of information and we are

fortunate to have you care enough to post your info on this site.

>

> Int Orthop. 2008 Aug;32(4):511-6. Epub 2007 Mar 20.

>

>

> Timing of cervical spine stabilisation and outcome in patients with

> rheumatoid arthritis.

>

>

> Schmitt-Sody M, Kirchhoff C, Buhmann S, Metz P, Birkenmaier C,

> Troullier H, Jansson V, Veihelmann A.

> Department of Orthopaedic Surgery, Campus Grosshadern,

> Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377,

> Munich, Germany.

>

>

> One complication of rheumatoid arthritis (RA) is the involvement of

> the cervical spine (CS). Although prophylactic stabilisation is

> recommended, the timing at which this should occur is poorly defined.

> The aim of our study was to evaluate the course of neurological

> symptoms in terms of the timing of surgery. A total of 34 patients

> with RA and CS involvement were surgically stabilised. These patients

> were classified using the Ranawat (RW) score both preoperatively and

> at an average of 54 months post-operatively. For each patient, the

> presence of atlantoaxial and subaxial subluxation as well as vertical

> migration of the odontoid was recorded. The anterior atlantodental

> interval was also assessed pre- and post-operatively. Improvement was

> obtained in 20 patients, the clinical situation remained unchanged in

> three patients and three patients manifested disease progression. In

> terms of the RW score, the 16 patients with pre-operative RW grades

> I-II showed no deterioration at the post-operative follow-up, with 13

> of these patients showing an improvement; the 12 patients with

> pre-operative RW grades IIIA-IIIB did not show any improvement of

> neurological symptoms at follow-up, although seven of these patients

> subjectively assessed the symptoms to be less severe after surgery;

> three other patients showed a worsening of symptoms. Our results

> suggest that preventive stabilisation of CS in RA leads to acceptable

> results, although the complications of the surgery are obvious.

> However, early operative treatment may delay the detrimental course of

> cervical myelopathy in RA.

>

>

> PMID: 17372732

>

> http://www.ncbi.nlm.nih.gov/pubmed/17372732

>

>

> --

>

> Not an MD

>

[Guest guest]

,

Sorry for my late reply.

It's awful that you've had so many problems with your spine.

Although cervical involvement is very common in RA, you won't

necessarily have problems.

I'm not sure what you are asking in your other question. Do you want

to know how RA can affect outcomes or produce changes that will

necessitate surgery?

Not an MD

On Tue, Jul 1, 2008 at 4:11 PM, kimriedlinger <kimriedlinger@...> wrote:

> Hi ,

>

> I had C-5,c-6 fused in 1996. I didn't recover well or quickly. it took

> 3 yrs to get to what i would call normal after the neck surgery. The

> DRs say it was because of the fibro. sounds like I was lucky to have

> it done before the RA reared its hugly head.I have minimal problems

> with my neck now.

> Within 2 yrs they did MRIs of my entire spine. several other discs

> are deteriorating. Some milder then others. L-5,s-1 doesn't have any

> fluid. When I move wrong they push on the spinal cord and then cause

> great pain and even lost on motor function some times.

> All my DRs agree that surgery should only be done as a last resort

> because of the complications of low back surgery and the fibro.

> you are talking about cerval stablization and RA. Do you have any

> insight on how can RA can affect other spinal surgeries? also, does

> this mean I might have more problems with my neck later from the RA.

>

> I know you are not a MD but you are a wealth of information and we are

> fortunate to have you care enough to post your info on this site.

>

>

[Guest guest]

,

I too have had C5/6 fusion done. I have " inflamatory polyarthritis " but not

necessarily RA. My discs are also losing flexibility, height, volume. My

surgeon calls it Degenerative Disc Disease. But even without RA or Degenerative

Disc Disease, the fusions are only made to last about 15 years. Recently I had

to go back to the surgeon about C4/5 disc as it is ruptured and the surgeon said

that is pretty normal with the 5/6 fusion. Because the 5/6 area can no longer

move, the discs above and below have to be overworked to make up for that

movement. Therefore, the discs above and below become more susceptible to

rupturing. So even without the other complications, you may have more trouble

with your neck.

Personally, I have opted out of surgery (against dr.'s wishes) because I am

tolerating the pain for now. My nerves are being compressed, but I am coping

for now. I know I will be back in for surgery again someday, but I'm not ready

for that incredible recovery again! Hopefully I can hold out until my fusion

wears out and by then, maybe those artificial discs will be covered by my

insurance!

, 36 years old.