Rybarczyk Marek, Koszela Kamil, Mańczak Małgorzata, Gasik Robert
Department of Neuroorthopedics, Mazovian Rehabilitation Center-STOCER, Konstancin-Jeziorna, Poland.
Department of Neuroorthopedics and Neurology Clinic and Polyclinic, National Institute of Geriatric, Rheumatology and Rehabilitation, Warsaw, Poland.
Rheumatol Int. 2025 Sep 2;45(9):213. doi: 10.1007/s00296-025-05980-7.
Rheumatoid arthritis (RA) is a chronic inflammatory joint disease characterized by a specific pattern of bone and joint destruction. Instability of C1-C2 can be seen in up to 65% of RA patients. Occipito-cervical fixation (OCF) protects spine from trauma damage and neurological deficit progression though it causes limitation of cervical movement. The aim of the study was to evaluate the change in the cervical lordosis angle after OCF in the course of C1-C2 instability in patients with RA. The patients studied all underwent OCF in the period of 1999-2018 in the Department of Neuroortopedia MCR STOCER. Thirty three patients with RA were considered. The data was analyzed retrospectively. Clinical data and radiological data such as X-rays were analyzed. The radiological evaluation of cervical lordosis angle C2-C7 (C2-C7 CL) before and after occipito-cervical fixation was performed. Cervical lordosis angles before and after OCF did not differ: 17 (IQR 10-30) vs. 20 (IQR 7-25); p = 0.158. The analysis showed no significant changes of cervical lordosis after OCF in rheumatoid patients. It can be result of surgical procedure careful performing. However, further research is necessary in this area.
类风湿性关节炎（RA）是一种慢性炎症性关节疾病，其特征是具有特定的骨和关节破坏模式。高达65%的RA患者可见C1-C2不稳定。枕颈固定（OCF）可保护脊柱免受创伤损害和神经功能缺损进展，尽管它会导致颈椎活动受限。本研究的目的是评估RA患者在C1-C2不稳定过程中进行OCF后颈椎前凸角的变化。本研究的患者均于1999年至2018年期间在MCR STOCER神经矫形科接受了OCF治疗。共纳入33例RA患者。对数据进行回顾性分析。分析临床数据和诸如X线等放射学数据。对枕颈固定前后的颈椎前凸角C2-C7（C2-C7 CL）进行放射学评估。OCF前后的颈椎前凸角无差异：17（四分位间距10-30）与20（四分位间距7-25）；p = 0.158。分析显示，RA患者OCF后颈椎前凸无显著变化。这可能是手术操作谨慎的结果。然而，该领域仍需进一步研究。
