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Surgical Management of the Lumbar Spine in Rheumatoid Arthritis

STUDY DESIGN: Narrative review. OBJECTIVE: To provide an overview on the diagnosis and surgical management of rheumatoid involvement of the lumbar spine. Rheumatoid arthritis (RA) is a chronic inflammatory disease of synovial joints, most commonly appendicular followed by axial. Although cervical sp...

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Detalles Bibliográficos
Autores principales: Joo, Peter, Ge, Laurence, Mesfin, Addisu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7383786/
https://www.ncbi.nlm.nih.gov/pubmed/32707025
http://dx.doi.org/10.1177/2192568219886267
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author Joo, Peter
Ge, Laurence
Mesfin, Addisu
author_facet Joo, Peter
Ge, Laurence
Mesfin, Addisu
author_sort Joo, Peter
collection PubMed
description STUDY DESIGN: Narrative review. OBJECTIVE: To provide an overview on the diagnosis and surgical management of rheumatoid involvement of the lumbar spine. Rheumatoid arthritis (RA) is a chronic inflammatory disease of synovial joints, most commonly appendicular followed by axial. Although cervical spine involvement of RA is well documented, data on lumbar spine involvement and surgical management remains limited. METHODS: Using PubMed, studies published prior to November 2018 with the keywords “RA, etiology”; “RA, spine management”; “RA, surgical management”; “RA, treatment”; “RA, DMARDs”; “RA, lumbar spine”; “RA, spine surgical outcomes”; “RA, imaging” were evaluated. RESULTS: The narrative review addresses the epidemiology, manifestations, imaging, surgical complications, and operative and nonoperative management of RA involvement of the lumbar spine. CONCLUSIONS: Rheumatoid involvement of the lumbar spine can present with lower back pain, neurogenic claudication, radiculopathy, spinal deformity, and instability. Patients with RA have significantly higher rates of vertebral fractures and complications following surgical intervention. However, in the setting of instability and spinal deformity, thoughtful surgical planning in conjunction with optimal medical management is recommended.
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spelling pubmed-73837862020-08-10 Surgical Management of the Lumbar Spine in Rheumatoid Arthritis Joo, Peter Ge, Laurence Mesfin, Addisu Global Spine J Review Articles STUDY DESIGN: Narrative review. OBJECTIVE: To provide an overview on the diagnosis and surgical management of rheumatoid involvement of the lumbar spine. Rheumatoid arthritis (RA) is a chronic inflammatory disease of synovial joints, most commonly appendicular followed by axial. Although cervical spine involvement of RA is well documented, data on lumbar spine involvement and surgical management remains limited. METHODS: Using PubMed, studies published prior to November 2018 with the keywords “RA, etiology”; “RA, spine management”; “RA, surgical management”; “RA, treatment”; “RA, DMARDs”; “RA, lumbar spine”; “RA, spine surgical outcomes”; “RA, imaging” were evaluated. RESULTS: The narrative review addresses the epidemiology, manifestations, imaging, surgical complications, and operative and nonoperative management of RA involvement of the lumbar spine. CONCLUSIONS: Rheumatoid involvement of the lumbar spine can present with lower back pain, neurogenic claudication, radiculopathy, spinal deformity, and instability. Patients with RA have significantly higher rates of vertebral fractures and complications following surgical intervention. However, in the setting of instability and spinal deformity, thoughtful surgical planning in conjunction with optimal medical management is recommended. SAGE Publications 2019-11-06 2020-09 /pmc/articles/PMC7383786/ /pubmed/32707025 http://dx.doi.org/10.1177/2192568219886267 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles
Joo, Peter
Ge, Laurence
Mesfin, Addisu
Surgical Management of the Lumbar Spine in Rheumatoid Arthritis
title Surgical Management of the Lumbar Spine in Rheumatoid Arthritis
title_full Surgical Management of the Lumbar Spine in Rheumatoid Arthritis
title_fullStr Surgical Management of the Lumbar Spine in Rheumatoid Arthritis
title_full_unstemmed Surgical Management of the Lumbar Spine in Rheumatoid Arthritis
title_short Surgical Management of the Lumbar Spine in Rheumatoid Arthritis
title_sort surgical management of the lumbar spine in rheumatoid arthritis
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7383786/
https://www.ncbi.nlm.nih.gov/pubmed/32707025
http://dx.doi.org/10.1177/2192568219886267
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