Change in the angle of cervical lordosis after occipito-cervical fixation in the course of instability of C1-C2 in patients with rheumatoid arthritis.

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.