抄録
Two cases of rheumatoid spondylitis in the lumbar region are reported. The first is a 65 y/o woman with a 27 year history of rheumatoid arthritis (RA) who had developed low back pain about one year before with progressive lumbar discitis on the L 3/4 level. A 64 y/o man whose onset of RA was in 1983 is the second case. His low back pain started one month prior to admission and progressive, destructive discitis was observed on the L 3/4 level likewise. Radiography revealed clear destruction of the end-plate of the L 3/4 disc in both patients. Surgical intervention was undertaken and anterior interbody fusion of the L 3/4 was performed, combined with Luque's segmental spinal instrumentation. Sections of the removed tissues demonstrated chronic inflammatory changes, most characteristic of which was granulomatous tissue invading into surrounding vertebral bones, quite reminiscent of rheumatoid pannus in the joints. No evidence of infection or malignancy was discovered. Thus, the diagnosis of rheumatoid spondylitis which is lacking in any specific findings can be made only by thoroughly ruling out other causes involving the vertebral discs.
