Abstract
The involvement of the cervical spine is a common complication of rheumatoid arthritis(RA). The inflammatory process can lead to progressive joint destruction and ligamentous laxity, which can result in cervical spine subluxation and instability. These anatomic deformities may cause the spinal cord or brain stem compression, with resultant neurological deficits, such as cervical myelopathy, paresis, and even death. Treatment paradigms for RA have recently undergone a major shift. Standard of care now entails initiating immediate treatment using aggressive therapy with disease-modifying antirheumatic drugs or a combination of disease-modifying antirheumatid drugs plus biological agents. Biological agents have been reported to reduce disease activity and retard or even halt structural damage to peripheral joints. However whether the strong disease-controlling activity of biological agents can also stave off or delay progression of cervical spine lesions in RA is not fully elucidated. In this manuscript the pathology, radiographic diagnosis and treatment strategy for cervical lesions are reviewed.
