Surgical treatment of the rheumatoid cervical spine in patients aged 70 years or older

• Published in: Rheumatology (Oxford, England) Vol. 41; no. 8; pp. 910 - 916
• Main Authors: Mizutani, J., Tsubouchi, S., Fukuoka, M., Otsuka, T., Matsui, N.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.08.2002; Oxford Publishing Limited (England)
• Subjects: Activity in daily living; Age Factors; Age of Onset; Aged; Arthritis, Rheumatoid - physiopathology; Arthritis, Rheumatoid - surgery; Biological and medical sciences; Cervical spine; Cervical Vertebrae - surgery; Elderly patients; Follow-Up Studies; Humans; Medical sciences; Orthopedic surgery; Pain - physiopathology; Posterior fixation; Quality of life; Rheumatoid arthritis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical treatment; Treatment Outcome; Human; Immunopathology; Prognosis; Indication; Diseases of the osteoarticular system; Autoimmune disease; Inflammatory joint disease; Arthritis; Inflammation; Spine disease; Quality of life; Chronic; Orthopedic surgery; Fixation; Treatment; Rheumatoid arthritis; Posterior; Technique; Elderly; Cervical spine
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/41.8.910

Objective. To investigate whether surgery is appropriate for elderly rheumatoid arthritis patients who are already approaching their statistical life expectancy. Patients and methods. The subjects were 10 patients who underwent cervical spine surgery for rheumatoid arthritis at an age of over 70 yr. The pain grade and neurological deficit class according to Ranawat, peri‐operative complications, causes of death and pre‐operative cardiopulmonary function were assessed. Results. Good pain relief was achieved. Relief of pain enabled the patients, who could not sit up even in bed because of intolerable neck pain, to ride in a wheel chair without using a neck collar. Only one death was related to surgery. Pre‐operative cardiopulmonary function was not significantly different compared with that of elderly patients undergoing other surgical procedures. Conclusion. Surgery is a valuable option for the management of elderly patients with rheumatoid cervical spine since it can improve the quality of life.