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Rheumatology 2002; 41: 910-916
© 2002 British Society for Rheumatology

Original Papers

Surgical treatment of the rheumatoid cervical spine in patients aged 70 years or older

J. Mizutani, S. Tsubouchi, M. Fukuoka, T. Otsuka and N. Matsui

Department of Orthopaedic Surgery, Nagoya City University Medical School, Nagoya, Japan

Objective. To investigate whether surgery is appropriate for elderly rheumatoid arthritis patients who are already approaching their statistical life expectancy.

Patients and methods. The subjects were 10 patients who underwent cervical spine surgery for rheumatoid arthritis at an age of over 70 yr. The pain grade and neurological deficit class according to Ranawat, peri-operative complications, causes of death and pre-operative cardiopulmonary function were assessed.

Results. Good pain relief was achieved. Relief of pain enabled the patients, who could not sit up even in bed because of intolerable neck pain, to ride in a wheel chair without using a neck collar. Only one death was related to surgery. Pre-operative cardiopulmonary function was not significantly different compared with that of elderly patients undergoing other surgical procedures.

Conclusion. Surgery is a valuable option for the management of elderly patients with rheumatoid cervical spine since it can improve the quality of life.

KEY WORDS: Rheumatoid arthritis, Cervical spine, Surgical treatment, Posterior fixation, Elderly patients, Quality of life, Activity in daily living.

Correspondence to: J. Mizutani, Department of Orthopaedic Surgery, Nagoya City University Medical School, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya-City, Aichi, 467-8601, Japan.


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