Cargando…

Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery

OBJECTIVE: Rheumatoid arthritis (RA) is a systemic disease that can affect the cervical spine, especially the atlantoaxial region. The present study evaluated the risk factors for atlantoaxial subluxation (AAS) development and progression in patients who have undergone surgical treatment. METHODS: W...

Descripción completa

Detalles Bibliográficos
Autores principales: Na, Min-Kyun, Chun, Hyoung-Joon, Bak, Koang-Hum, Yi, Hyeong-Joong, Ryu, Je Il, Han, Myung-Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Neurosurgical Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106358/
https://www.ncbi.nlm.nih.gov/pubmed/27847572
http://dx.doi.org/10.3340/jkns.2016.59.6.590
_version_ 1782467034982907904
author Na, Min-Kyun
Chun, Hyoung-Joon
Bak, Koang-Hum
Yi, Hyeong-Joong
Ryu, Je Il
Han, Myung-Hoon
author_facet Na, Min-Kyun
Chun, Hyoung-Joon
Bak, Koang-Hum
Yi, Hyeong-Joong
Ryu, Je Il
Han, Myung-Hoon
author_sort Na, Min-Kyun
collection PubMed
description OBJECTIVE: Rheumatoid arthritis (RA) is a systemic disease that can affect the cervical spine, especially the atlantoaxial region. The present study evaluated the risk factors for atlantoaxial subluxation (AAS) development and progression in patients who have undergone surgical treatment. METHODS: We retrospectively analyzed the data of 62 patients with RA and surgically treated AAS between 2002 and 2015. Additionally, we identified 62 patients as controls using propensity score matching of sex and age among 12667 RA patients from a rheumatology registry between 2007 and 2015. We extracted patient data, including sex, age at diagnosis, age at surgery, disease duration, radiographic hand joint changes, and history of methotrexate use, and laboratory data, including presence of rheumatoid factor and the C-reactive protein (CRP) level. RESULTS: The mean patient age at diagnosis was 38.0 years. The mean time interval between RA diagnosis and AAS surgery was 13.6±7.0 years. The risk factors for surgically treated AAS development were the serum CRP level (p=0.005) and radiographic hand joint erosion (p=0.009). The risk factors for AAS progression were a short time interval between RA diagnosis and radiographic hand joint erosion (p<0.001) and young age at RA diagnosis (p=0.04). CONCLUSION: The CRP level at RA diagnosis and a short time interval between RA diagnosis and radiographic hand joint erosion might be risk factors for surgically treated AAS development in RA patients. Additionally, a short time interval between RA diagnosis and radiographic hand joint erosion and young age at RA diagnosis might be risk factors for AAS progression.
format Online
Article
Text
id pubmed-5106358
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher The Korean Neurosurgical Society
record_format MEDLINE/PubMed
spelling pubmed-51063582016-11-15 Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery Na, Min-Kyun Chun, Hyoung-Joon Bak, Koang-Hum Yi, Hyeong-Joong Ryu, Je Il Han, Myung-Hoon J Korean Neurosurg Soc Clinical Article OBJECTIVE: Rheumatoid arthritis (RA) is a systemic disease that can affect the cervical spine, especially the atlantoaxial region. The present study evaluated the risk factors for atlantoaxial subluxation (AAS) development and progression in patients who have undergone surgical treatment. METHODS: We retrospectively analyzed the data of 62 patients with RA and surgically treated AAS between 2002 and 2015. Additionally, we identified 62 patients as controls using propensity score matching of sex and age among 12667 RA patients from a rheumatology registry between 2007 and 2015. We extracted patient data, including sex, age at diagnosis, age at surgery, disease duration, radiographic hand joint changes, and history of methotrexate use, and laboratory data, including presence of rheumatoid factor and the C-reactive protein (CRP) level. RESULTS: The mean patient age at diagnosis was 38.0 years. The mean time interval between RA diagnosis and AAS surgery was 13.6±7.0 years. The risk factors for surgically treated AAS development were the serum CRP level (p=0.005) and radiographic hand joint erosion (p=0.009). The risk factors for AAS progression were a short time interval between RA diagnosis and radiographic hand joint erosion (p<0.001) and young age at RA diagnosis (p=0.04). CONCLUSION: The CRP level at RA diagnosis and a short time interval between RA diagnosis and radiographic hand joint erosion might be risk factors for surgically treated AAS development in RA patients. Additionally, a short time interval between RA diagnosis and radiographic hand joint erosion and young age at RA diagnosis might be risk factors for AAS progression. The Korean Neurosurgical Society 2016-11 2016-10-24 /pmc/articles/PMC5106358/ /pubmed/27847572 http://dx.doi.org/10.3340/jkns.2016.59.6.590 Text en Copyright © 2016 The Korean Neurosurgical Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Article
Na, Min-Kyun
Chun, Hyoung-Joon
Bak, Koang-Hum
Yi, Hyeong-Joong
Ryu, Je Il
Han, Myung-Hoon
Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery
title Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery
title_full Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery
title_fullStr Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery
title_full_unstemmed Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery
title_short Risk Factors for the Development and Progression of Atlantoaxial Subluxation in Surgically Treated Rheumatoid Arthritis Patients, Considering the Time Interval between Rheumatoid Arthritis Diagnosis and Surgery
title_sort risk factors for the development and progression of atlantoaxial subluxation in surgically treated rheumatoid arthritis patients, considering the time interval between rheumatoid arthritis diagnosis and surgery
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106358/
https://www.ncbi.nlm.nih.gov/pubmed/27847572
http://dx.doi.org/10.3340/jkns.2016.59.6.590
work_keys_str_mv AT naminkyun riskfactorsforthedevelopmentandprogressionofatlantoaxialsubluxationinsurgicallytreatedrheumatoidarthritispatientsconsideringthetimeintervalbetweenrheumatoidarthritisdiagnosisandsurgery
AT chunhyoungjoon riskfactorsforthedevelopmentandprogressionofatlantoaxialsubluxationinsurgicallytreatedrheumatoidarthritispatientsconsideringthetimeintervalbetweenrheumatoidarthritisdiagnosisandsurgery
AT bakkoanghum riskfactorsforthedevelopmentandprogressionofatlantoaxialsubluxationinsurgicallytreatedrheumatoidarthritispatientsconsideringthetimeintervalbetweenrheumatoidarthritisdiagnosisandsurgery
AT yihyeongjoong riskfactorsforthedevelopmentandprogressionofatlantoaxialsubluxationinsurgicallytreatedrheumatoidarthritispatientsconsideringthetimeintervalbetweenrheumatoidarthritisdiagnosisandsurgery
AT ryujeil riskfactorsforthedevelopmentandprogressionofatlantoaxialsubluxationinsurgicallytreatedrheumatoidarthritispatientsconsideringthetimeintervalbetweenrheumatoidarthritisdiagnosisandsurgery
AT hanmyunghoon riskfactorsforthedevelopmentandprogressionofatlantoaxialsubluxationinsurgicallytreatedrheumatoidarthritispatientsconsideringthetimeintervalbetweenrheumatoidarthritisdiagnosisandsurgery