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Erschienen in: rheuma plus 4/2018

29.01.2018 | Chirurgie

Die rheumatische Halswirbelsäule

verfasst von: Dr. M. Schroeder, W. Rüther, C. Schaefer

Erschienen in: rheuma plus | Ausgabe 4/2018

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Zusammenfassung

Hintergrund

Die Halswirbelsäule ist bei der rheumatoiden Arthritis eine der Hauptmanifestationsorte außerhalb der Extremitäten. Sie kann durch das Auftreten mechanischer Instabilitäten sowie neurologischer Symptome einen entscheidenden Einfluss auf den Krankheitsverlauf nehmen. Sowohl die adäquate Diagnosestellung als auch die entsprechende chirurgische Behandlung stellen eine Herausforderung für behandelnde Ärzte dar.

Material und Methoden

In dieser Übersichtsarbeit werden relevante diagnostische Strategien und chirurgische Interventionsmöglichkeiten vorgestellt, deren Ziel die Vermeidung potenziell fataler neurologischer Symptome ist. Darüber hinaus werden Grundlagenarbeiten und Expertenmeinungen diskutiert.

Ergebnisse und Diskussion

Durch ein zeitgerechtes chirurgisches Vorgehen sowie engmaschige klinische und radiologische Kontrollen unter konservativer und nach chirurgischer Therapie lassen sich für Patienten potenziell fatale Verläufe vermeiden.
Literatur
1.
Zurück zum Zitat Agarwal AK, Peppelman WC, Kraus DR et al (1992) Recurrence of cervical spine instability in rheumatoid arthritis following previous fusion: can disease progression be prevented by early surgery? J Rheumatol 19:1364–1370 PubMed Agarwal AK, Peppelman WC, Kraus DR et al (1992) Recurrence of cervical spine instability in rheumatoid arthritis following previous fusion: can disease progression be prevented by early surgery? J Rheumatol 19:1364–1370 PubMed
2.
Zurück zum Zitat Alosh H, Parker SL, Mcgirt MJ et al (2010) Preoperative radiographic factors and surgeon experience are associated with cortical breach of C2 pedicle screws. J Spinal Disord Tech 23:9–14 CrossRefPubMed Alosh H, Parker SL, Mcgirt MJ et al (2010) Preoperative radiographic factors and surgeon experience are associated with cortical breach of C2 pedicle screws. J Spinal Disord Tech 23:9–14 CrossRefPubMed
3.
Zurück zum Zitat Bell GR, Stearns KL (1991) Flexion-extension MRI of the upper rheumatoid cervical spine. Orthopedics 14:969–973 (discussion 973–964) PubMed Bell GR, Stearns KL (1991) Flexion-extension MRI of the upper rheumatoid cervical spine. Orthopedics 14:969–973 (discussion 973–964) PubMed
4.
Zurück zum Zitat Boden SD, Dodge LD, Bohlman HH et al (1993) Rheumatoid arthritis of the cervical spine. A long-term analysis with predictors of paralysis and recovery. J Bone Joint Surg Am 75:1282–1297 CrossRefPubMed Boden SD, Dodge LD, Bohlman HH et al (1993) Rheumatoid arthritis of the cervical spine. A long-term analysis with predictors of paralysis and recovery. J Bone Joint Surg Am 75:1282–1297 CrossRefPubMed
5.
Zurück zum Zitat Bundschuh C, Modic MT, Kearney F et al (1988) Rheumatoid arthritis of the cervical spine: surface-coil MR imaging. AJR Am J Roentgenol 151:181–187 CrossRefPubMed Bundschuh C, Modic MT, Kearney F et al (1988) Rheumatoid arthritis of the cervical spine: surface-coil MR imaging. AJR Am J Roentgenol 151:181–187 CrossRefPubMed
6.
Zurück zum Zitat Casey AT, Crockard HA, Bland JM et al (1996) Predictors of outcome in the quadriparetic nonambulatory myelopathic patient with rheumatoid arthritis: a prospective study of 55 surgically treated Ranawat class IIIb patients. J Neurosurg 85:574–581 CrossRefPubMed Casey AT, Crockard HA, Bland JM et al (1996) Predictors of outcome in the quadriparetic nonambulatory myelopathic patient with rheumatoid arthritis: a prospective study of 55 surgically treated Ranawat class IIIb patients. J Neurosurg 85:574–581 CrossRefPubMed
7.
Zurück zum Zitat Clark CR, Goetz DD, Menezes AH (1989) Arthrodesis of the cervical spine in rheumatoid arthritis. J Bone Joint Surg Am 71:381–392 CrossRefPubMed Clark CR, Goetz DD, Menezes AH (1989) Arthrodesis of the cervical spine in rheumatoid arthritis. J Bone Joint Surg Am 71:381–392 CrossRefPubMed
8.
Zurück zum Zitat Clarke MJ, Cohen-Gadol AA, Ebersold MJ et al (2006) Long-term incidence of subaxial cervical spine instability following cervical arthrodesis surgery in patients with rheumatoid arthritis. Surg Neurol 66:136–140 (discussion 140) CrossRefPubMed Clarke MJ, Cohen-Gadol AA, Ebersold MJ et al (2006) Long-term incidence of subaxial cervical spine instability following cervical arthrodesis surgery in patients with rheumatoid arthritis. Surg Neurol 66:136–140 (discussion 140) CrossRefPubMed
9.
Zurück zum Zitat Crockard HA, Calder I, Ransford AO (1990) One-stage transoral decompression and posterior fixation in rheumatoid atlanto-axial subluxation. J Bone Joint Surg Br 72:682–685 CrossRefPubMed Crockard HA, Calder I, Ransford AO (1990) One-stage transoral decompression and posterior fixation in rheumatoid atlanto-axial subluxation. J Bone Joint Surg Br 72:682–685 CrossRefPubMed
10.
Zurück zum Zitat Da Corte FC, Neves N (2014) Cervical spine instability in rheumatoid arthritis. Eur J Orthop Surg Traumatol 24(Suppl 1):S83–S91 PubMed Da Corte FC, Neves N (2014) Cervical spine instability in rheumatoid arthritis. Eur J Orthop Surg Traumatol 24(Suppl 1):S83–S91 PubMed
11.
Zurück zum Zitat Dasenbrock HH, Clarke MJ, Bydon A et al (2012) Endoscopic image-guided transcervical odontoidectomy: outcomes of 15 patients with basilar invagination. Neurosurgery 70:351–359 (discussion 359–360) CrossRefPubMed Dasenbrock HH, Clarke MJ, Bydon A et al (2012) Endoscopic image-guided transcervical odontoidectomy: outcomes of 15 patients with basilar invagination. Neurosurgery 70:351–359 (discussion 359–360) CrossRefPubMed
12.
Zurück zum Zitat Ebraheim N, Rollins JR Jr., Xu R et al (1996) Anatomic consideration of C2 pedicle screw placement. Spine 21:691–695 CrossRefPubMed Ebraheim N, Rollins JR Jr., Xu R et al (1996) Anatomic consideration of C2 pedicle screw placement. Spine 21:691–695 CrossRefPubMed
13.
Zurück zum Zitat Elliott RE, Tanweer O, Boah A et al (2014) Outcome comparison of atlantoaxial fusion with transarticular screws and screw-rod constructs: meta-analysis and review of literature. J Spinal Disord Tech 27:11–28 CrossRefPubMed Elliott RE, Tanweer O, Boah A et al (2014) Outcome comparison of atlantoaxial fusion with transarticular screws and screw-rod constructs: meta-analysis and review of literature. J Spinal Disord Tech 27:11–28 CrossRefPubMed
16.
Zurück zum Zitat Grob D, Magerl F (1987) Surgical stabilization of C1 and C2 fractures. Orthopäde 16:46–54 PubMed Grob D, Magerl F (1987) Surgical stabilization of C1 and C2 fractures. Orthopäde 16:46–54 PubMed
17.
Zurück zum Zitat Harms J, Melcher RP (2001) Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine 26:2467–2471 CrossRefPubMed Harms J, Melcher RP (2001) Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine 26:2467–2471 CrossRefPubMed
18.
Zurück zum Zitat Heller JG, Carlson GD, Abitbol JJ et al (1991) Anatomic comparison of the Roy-Camille and Magerl techniques for screw placement in the lower cervical spine. Spine 16:S552–S557 CrossRefPubMed Heller JG, Carlson GD, Abitbol JJ et al (1991) Anatomic comparison of the Roy-Camille and Magerl techniques for screw placement in the lower cervical spine. Spine 16:S552–S557 CrossRefPubMed
19.
Zurück zum Zitat Hirano K, Imagama S, Oishi Y et al (2012) Progression of cervical instabilities in patients with rheumatoid arthritis 5.7 years after their first lower limb arthroplasty. Mod Rheumatol 22:743–749 CrossRefPubMed Hirano K, Imagama S, Oishi Y et al (2012) Progression of cervical instabilities in patients with rheumatoid arthritis 5.7 years after their first lower limb arthroplasty. Mod Rheumatol 22:743–749 CrossRefPubMed
20.
Zurück zum Zitat Imagama S, Oishi Y, Miura Y et al (2010) Predictors of aggravation of cervical spine instability in rheumatoid arthritis patients: the large joint index. J Orthop Sci 15:540–546 CrossRefPubMed Imagama S, Oishi Y, Miura Y et al (2010) Predictors of aggravation of cervical spine instability in rheumatoid arthritis patients: the large joint index. J Orthop Sci 15:540–546 CrossRefPubMed
21.
Zurück zum Zitat Ishii K, Matsumoto M, Takahashi Y et al (2010) Risk factors for development of subaxial subluxations following atlantoaxial arthrodesis for atlantoaxial subluxations in rheumatoid arthritis. Spine 35:1551–1555 CrossRefPubMed Ishii K, Matsumoto M, Takahashi Y et al (2010) Risk factors for development of subaxial subluxations following atlantoaxial arthrodesis for atlantoaxial subluxations in rheumatoid arthritis. Spine 35:1551–1555 CrossRefPubMed
22.
Zurück zum Zitat Ito H, Neo M, Sakamoto T et al (2009) Subaxial subluxation after atlantoaxial transarticular screw fixation in rheumatoid patients. Eur Spine J 18:869–876 CrossRefPubMedPubMedCentral Ito H, Neo M, Sakamoto T et al (2009) Subaxial subluxation after atlantoaxial transarticular screw fixation in rheumatoid patients. Eur Spine J 18:869–876 CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Joaquim AF, Appenzeller S (2014) Cervical spine involvement in rheumatoid arthritis – a systematic review. Autoimmun Rev 13:1195–1202 CrossRefPubMed Joaquim AF, Appenzeller S (2014) Cervical spine involvement in rheumatoid arthritis – a systematic review. Autoimmun Rev 13:1195–1202 CrossRefPubMed
24.
Zurück zum Zitat Kassam AB, Snyderman C, Gardner P et al (2005) The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report. Neurosurgery 57:E213 (discussion E213) PubMed Kassam AB, Snyderman C, Gardner P et al (2005) The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report. Neurosurgery 57:E213 (discussion E213) PubMed
26.
Zurück zum Zitat Krauss WE, Bledsoe JM, Clarke MJ et al (2010) Rheumatoid arthritis of the craniovertebral junction. Neurosurgery 66:83–95 CrossRefPubMed Krauss WE, Bledsoe JM, Clarke MJ et al (2010) Rheumatoid arthritis of the craniovertebral junction. Neurosurgery 66:83–95 CrossRefPubMed
27.
Zurück zum Zitat Kroft LJ, Reijnierse M, Kloppenburg M et al (2004) Rheumatoid arthritis: epidural enhancement as an underestimated cause of subaxial cervical spinal stenosis. Radiology 231:57–63 CrossRefPubMed Kroft LJ, Reijnierse M, Kloppenburg M et al (2004) Rheumatoid arthritis: epidural enhancement as an underestimated cause of subaxial cervical spinal stenosis. Radiology 231:57–63 CrossRefPubMed
28.
Zurück zum Zitat Lapsiwala SB, Anderson PA, Oza A et al (2006) Biomechanical comparison of four C1 to C2 rigid fixative techniques: anterior transarticular, posterior transarticular, C1 to C2 pedicle, and C1 to C2 intralaminar screws. Neurosurgery 58:516–521 (discussion 516–521) CrossRefPubMed Lapsiwala SB, Anderson PA, Oza A et al (2006) Biomechanical comparison of four C1 to C2 rigid fixative techniques: anterior transarticular, posterior transarticular, C1 to C2 pedicle, and C1 to C2 intralaminar screws. Neurosurgery 58:516–521 (discussion 516–521) CrossRefPubMed
29.
Zurück zum Zitat Linos A, Worthington JW, O’fallon WM et al (1980) The epidemiology of rheumatoid arthritis in Rochester, Minnesota: a study of incidence, prevalence, and mortality. Am J Epidemiol 111:87–98 CrossRefPubMed Linos A, Worthington JW, O’fallon WM et al (1980) The epidemiology of rheumatoid arthritis in Rochester, Minnesota: a study of incidence, prevalence, and mortality. Am J Epidemiol 111:87–98 CrossRefPubMed
30.
Zurück zum Zitat Mcrorie ER, Mcloughlin P, Russell T et al (1996) Cervical spine surgery in patients with rheumatoid arthritis: an appraisal. Ann Rheum Dis 55:99–104 CrossRefPubMedPubMedCentral Mcrorie ER, Mcloughlin P, Russell T et al (1996) Cervical spine surgery in patients with rheumatoid arthritis: an appraisal. Ann Rheum Dis 55:99–104 CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Miyamoto H, Sumi M, Uno K (2013) Outcome of surgery for rheumatoid cervical spine at one institute over three decades. Spine J 13:1477–1484 CrossRefPubMed Miyamoto H, Sumi M, Uno K (2013) Outcome of surgery for rheumatoid cervical spine at one institute over three decades. Spine J 13:1477–1484 CrossRefPubMed
32.
Zurück zum Zitat Mori T, Matsunaga S, Sunahara N et al (1998) 3‑ to 11-year followup of occipitocervical fusion for rheumatoid arthritis. Clin Orthop Relat Res 1998(351):169–179 Mori T, Matsunaga S, Sunahara N et al (1998) 3‑ to 11-year followup of occipitocervical fusion for rheumatoid arthritis. Clin Orthop Relat Res 1998(351):169–179
33.
Zurück zum Zitat Nannapaneni R, Behari S, Todd NV (2005) Surgical outcome in rheumatoid ranawat class IIIb myelopathy. Neurosurgery 56:706–715 (discussion 706–715) CrossRefPubMed Nannapaneni R, Behari S, Todd NV (2005) Surgical outcome in rheumatoid ranawat class IIIb myelopathy. Neurosurgery 56:706–715 (discussion 706–715) CrossRefPubMed
34.
Zurück zum Zitat Nguyen HV, Ludwig SC, Silber J et al (2004) Rheumatoid arthritis of the cervical spine. Spine J 4:329–334 CrossRefPubMed Nguyen HV, Ludwig SC, Silber J et al (2004) Rheumatoid arthritis of the cervical spine. Spine J 4:329–334 CrossRefPubMed
35.
Zurück zum Zitat Omura K, Hukuda S, Katsuura A et al (2002) Evaluation of posterior long fusion versus conservative treatment for the progressive rheumatoid cervical spine. Spine 27:1336–1345 CrossRefPubMed Omura K, Hukuda S, Katsuura A et al (2002) Evaluation of posterior long fusion versus conservative treatment for the progressive rheumatoid cervical spine. Spine 27:1336–1345 CrossRefPubMed
36.
Zurück zum Zitat Paus AC, Steen H, Roislien J et al (2008) High mortality rate in rheumatoid arthritis with subluxation of the cervical spine: a cohort study of operated and nonoperated patients. Spine 33:2278–2283 CrossRefPubMed Paus AC, Steen H, Roislien J et al (2008) High mortality rate in rheumatoid arthritis with subluxation of the cervical spine: a cohort study of operated and nonoperated patients. Spine 33:2278–2283 CrossRefPubMed
37.
Zurück zum Zitat Pellicci PM, Ranawat CS, Tsairis P et al (1981) A prospective study of the progression of rheumatoid arthritis of the cervical spine. J Bone Joint Surg Am 63:342–350 CrossRefPubMed Pellicci PM, Ranawat CS, Tsairis P et al (1981) A prospective study of the progression of rheumatoid arthritis of the cervical spine. J Bone Joint Surg Am 63:342–350 CrossRefPubMed
38.
Zurück zum Zitat Ranawat CS, O’leary P, Pellicci P et al (1979) Cervical spine fusion in rheumatoid arthritis. J Bone Joint Surg Am 61:1003–1010 CrossRefPubMed Ranawat CS, O’leary P, Pellicci P et al (1979) Cervical spine fusion in rheumatoid arthritis. J Bone Joint Surg Am 61:1003–1010 CrossRefPubMed
39.
Zurück zum Zitat Redlund-Johnell I, Pettersson H (1984) Radiographic measurements of the cranio-vertebral region. Designed for evaluation of abnormalities in rheumatoid arthritis. Acta Radiol Diagn (Stockh) 25:23–28 CrossRef Redlund-Johnell I, Pettersson H (1984) Radiographic measurements of the cranio-vertebral region. Designed for evaluation of abnormalities in rheumatoid arthritis. Acta Radiol Diagn (Stockh) 25:23–28 CrossRef
40.
Zurück zum Zitat Reijnierse M, Breedveld FC, Kroon HM et al (2000) Are magnetic resonance flexion views useful in evaluating the cervical spine of patients with rheumatoid arthritis? Skeletal Radiol 29:85–89 CrossRefPubMed Reijnierse M, Breedveld FC, Kroon HM et al (2000) Are magnetic resonance flexion views useful in evaluating the cervical spine of patients with rheumatoid arthritis? Skeletal Radiol 29:85–89 CrossRefPubMed
41.
Zurück zum Zitat Riew KD, Hilibrand AS, Palumbo MA et al (2001) Diagnosing basilar invagination in the rheumatoid patient. The reliability of radiographic criteria. J Bone Joint Surg Am 83–A:194–200 CrossRefPubMed Riew KD, Hilibrand AS, Palumbo MA et al (2001) Diagnosing basilar invagination in the rheumatoid patient. The reliability of radiographic criteria. J Bone Joint Surg Am 83–A:194–200 CrossRefPubMed
42.
Zurück zum Zitat Schaefer C, Begemann P, Fuhrhop I et al (2011) Percutaneous instrumentation of the cervical and cervico-thoracic spine using pedicle screws: preliminary clinical results and analysis of accuracy. Eur Spine J 20:977–985 CrossRefPubMedPubMedCentral Schaefer C, Begemann P, Fuhrhop I et al (2011) Percutaneous instrumentation of the cervical and cervico-thoracic spine using pedicle screws: preliminary clinical results and analysis of accuracy. Eur Spine J 20:977–985 CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Sunahara N, Matsunaga S, Mori T et al (1997) Clinical course of conservatively managed rheumatoid arthritis patients with myelopathy. Spine 22:2603–2607 (discussion 2608) CrossRefPubMed Sunahara N, Matsunaga S, Mori T et al (1997) Clinical course of conservatively managed rheumatoid arthritis patients with myelopathy. Spine 22:2603–2607 (discussion 2608) CrossRefPubMed
44.
Zurück zum Zitat Tanaka N, Sakahashi H, Hirose K et al (2005) Results after 24 years of prophylactic surgery for rheumatoid atlantoaxial subluxation. J Bone Joint Surg Br 87:955–958 CrossRefPubMed Tanaka N, Sakahashi H, Hirose K et al (2005) Results after 24 years of prophylactic surgery for rheumatoid atlantoaxial subluxation. J Bone Joint Surg Br 87:955–958 CrossRefPubMed
45.
Zurück zum Zitat Tehranzadeh J, Ashikyan O, Dascalos J (2003) Magnetic resonance imaging in early detection of rheumatoid arthritis. Semin Musculoskelet Radiol 7:79–94 CrossRefPubMed Tehranzadeh J, Ashikyan O, Dascalos J (2003) Magnetic resonance imaging in early detection of rheumatoid arthritis. Semin Musculoskelet Radiol 7:79–94 CrossRefPubMed
46.
Zurück zum Zitat Uitvlugt G, Indenbaum S (1988) Clinical assessment of atlantoaxial instability using the Sharp-Purser test. Arthritis Rheum 31:918–922 CrossRefPubMed Uitvlugt G, Indenbaum S (1988) Clinical assessment of atlantoaxial instability using the Sharp-Purser test. Arthritis Rheum 31:918–922 CrossRefPubMed
47.
Zurück zum Zitat Wagner SC, Formby PM, Helgeson MD et al (2016) Diagnosing the undiagnosed: osteoporosis in patients undergoing lumbar fusion. Spine 41(1976):E1279–E1283 CrossRefPubMed Wagner SC, Formby PM, Helgeson MD et al (2016) Diagnosing the undiagnosed: osteoporosis in patients undergoing lumbar fusion. Spine 41(1976):E1279–E1283 CrossRefPubMed
48.
Zurück zum Zitat Wasserman BR, Moskovich R, Razi AE (2011) Rheumatoid arthritis of the cervical spine –‑clinical considerations. Bull NYU Hosp Jt Dis 69:136–148 PubMed Wasserman BR, Moskovich R, Razi AE (2011) Rheumatoid arthritis of the cervical spine –‑clinical considerations. Bull NYU Hosp Jt Dis 69:136–148 PubMed
49.
Zurück zum Zitat White AA, Panjabi MM (1978) Clinical biomechanics of the spine. Lippincott Williams & Wilkins, Philadelphia White AA, Panjabi MM (1978) Clinical biomechanics of the spine. Lippincott Williams & Wilkins, Philadelphia
50.
Zurück zum Zitat Winfield J, Cooke D, Brook AS et al (1981) A prospective study of the radiological changes in the cervical spine in early rheumatoid disease. Ann Rheum Dis 40:109–114 CrossRefPubMedPubMedCentral Winfield J, Cooke D, Brook AS et al (1981) A prospective study of the radiological changes in the cervical spine in early rheumatoid disease. Ann Rheum Dis 40:109–114 CrossRefPubMedPubMedCentral
51.
Zurück zum Zitat Wright NM (2004) Posterior C2 fixation using bilateral, crossing C2 laminar screws: case series and technical note. J Spinal Disord Tech 17:158–162 CrossRefPubMed Wright NM (2004) Posterior C2 fixation using bilateral, crossing C2 laminar screws: case series and technical note. J Spinal Disord Tech 17:158–162 CrossRefPubMed
52.
Zurück zum Zitat Yurube T, Sumi M, Nishida K et al (2014) Accelerated development of cervical spine instabilities in rheumatoid arthritis: a prospective minimum 5‑year cohort study. PLOS ONE 9:e88970 CrossRefPubMedPubMedCentral Yurube T, Sumi M, Nishida K et al (2014) Accelerated development of cervical spine instabilities in rheumatoid arthritis: a prospective minimum 5‑year cohort study. PLOS ONE 9:e88970 CrossRefPubMedPubMedCentral
53.
54.
Zurück zum Zitat Zikou AK, Alamanos Y, Argyropoulou MI et al (2005) Radiological cervical spine involvement in patients with rheumatoid arthritis: a cross sectional study. J Rheumatol 32:801–806 PubMed Zikou AK, Alamanos Y, Argyropoulou MI et al (2005) Radiological cervical spine involvement in patients with rheumatoid arthritis: a cross sectional study. J Rheumatol 32:801–806 PubMed
Metadaten
Titel
Die rheumatische Halswirbelsäule
verfasst von
Dr. M. Schroeder
W. Rüther
C. Schaefer
Publikationsdatum
29.01.2018
Verlag
Springer Vienna
Erschienen in
rheuma plus / Ausgabe 4/2018
Print ISSN: 1868-260X
Elektronische ISSN: 2191-2610
DOI
https://doi.org/10.1007/s12688-018-0153-7