Kirk A P, Patel U, Phillips H, Cardoe N
Br J Rheumatol. 1987 Aug;26(4):275-8. doi: 10.1093/rheumatology/26.4.275.
The incidence of cervical myelopathy and subluxation was investigated in 48 patients with rheumatoid disease who had three or more major lower limb joint replacements. Eight (17%) developed cervical myelopathy requiring cervical fusion. This was the subsequent cause of death in two. Four further patients demonstrated clinical features of myelopathy. Cervical subluxation was present in 29 of 44 (66%) in whom adequate radiographs were available. The development of cervical symptoms and signs could not have been predicted from the sex, age of onset, duration of disease or steroid therapy. Radiographic changes in the cervical spine were independent of major lower limb joint destruction and were often not present when planning a programme of joint replacement. Fifty-one control patients were studied. Cervical myelopathy occurred in 2 (4%) and subluxation in 24 (47%). The development of rheumatoid changes in the cervical spine was unrelated to involvement of the hip or knee joints in the control group. There was a significant (p less than 0.05) increase in the incidence of cervical myelopathy in patients with multiple lower limb joint replacements compared with the control population.
对48例患有类风湿性疾病且接受过三次或更多次主要下肢关节置换的患者，研究了颈椎脊髓病和半脱位的发生率。8例（17%）出现了需要颈椎融合的颈椎脊髓病。其中2例随后死亡。另有4例患者表现出脊髓病的临床特征。在有足够X线片的44例患者中，29例（66%）存在颈椎半脱位。无法根据性别、发病年龄、病程或类固醇治疗来预测颈椎症状和体征的出现。颈椎的X线改变与主要下肢关节破坏无关，在制定关节置换计划时往往不存在。研究了51例对照患者。2例（4%）发生颈椎脊髓病，24例（47%）发生半脱位。对照组中颈椎类风湿性改变的发生与髋关节或膝关节受累无关。与对照人群相比，多次下肢关节置换患者的颈椎脊髓病发生率显著增加（p<0.05）。
