Management of metastatic cervical spine tumors.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 17. Orthopade. 2018 Jun;47(6):489-495. doi: 10.1007/s00132-018-3563-2. [Rheumatoid instability in the cervical spine : Diagnostic and therapeutic strategies]. [Article in German] Kothe R(1). Author information: (1)Klinik für Spinale Chirurgie, Schön Klinik Eilbek, Dehnhaide 120, 22081, Hamburg, Deutschland. rkothe@schoen-kliniken.de. BACKGROUND: The involvement of the cervical spine in rheumatoid arthritis (RA) continues to be of clinical importance even in this age of biologics. Pathophysiological changes begin with an isolated atlantoaxial subluxation and may progress to a complex craniocervical and subaxial instability. The onset of cervical myelopathy can occur at any time and leads to a deterioration of the prognosis for the patient. THERAPY: Treatment of the rheumatoid cervical spine should be aimed at improvement of the symptoms and prevention of further progress of the disease. In the case of instability, this is only possible by surgical treatment. The increasing usage of biological agents has led to a change in the clinical picture of the cervical involvement in RA patients. There are fewer patients presenting with isolated atlantoaxial instability. In contrast, the number of patients with complex craniocervical and/or subaxial instabilities is increasing. Complex cervical instabilities may require a longer fusion from the occiput to the upper thoracic spine. Modern operative techniques make this complex surgery also possible in severely disabled patients with a high comorbidity. DOI: 10.1007/s00132-018-3563-2