Cervical Arthritis (Rheumatoid Arthritis)
Rheumatoid arthritis (RA) is an autoimmune disease that inflames and destroys the lining of the joints in the body, called the synovial tissue. Cervical arthritis can result in neurological damage and possible paraplegia .
Signs and symptoms
Common symptoms of cervical arthritis include:
- Neck pain
- Weakness or numbness
- Stiffness of the neck
- Difficulty with movement or coordination of the arms and hands
- Low-grade fever
- Discomfort or malaise
- Loss of appetite
RA is different than osteoarthritis. RA is a chronic autoimmune disease. With RA, the immune system attacks healthy tissues in the body in addition to bacteria and viruses. Left untreated, the joints being attacked may start to lose mobility and become deformed.
Diagnosis of cervical arthritis starts with a physical exam and medical history. Other procedures and tests may be needed to diagnose RA, including: x-rays , computed tomography (CT) magnetic resonance imaging (MRI), and blood tests to check the levels of rheumatoid factor (RF) and anti-nuclear antigen (ANA).
There are several treatment options for cervical arthritis:
- Minimally invasive posterior cervical discectomy. This procedure is usually performed because of nerve root compression. During surgery, a small incision will be made on the back of your neck. Your surgeon will remove bone and ligament to get access to the spinal canal. Using a microscope, the nerve will be identified and the pressure will be taken off by removing disc material. During this surgery, no fusion will be performed. Surgery typically takes 1 – 2 hours and typically you go home the same day.
- Cervical decompression and fusion. This surgery is usually done for degenerative conditions of the spine. First, an incision is made on the front or back of the neck, depending on surgeon preference and your anatomy. The compressive pathology is removed very carefully, as the nerves in that area are very delicate. A metal plate and screws are secured to the spine so the bones of that segment will heal/fuse and remain stable.
- Facet joint injection/medial branch nerve block. A small needle is advanced with the help of a fluoroscopy or x-ray machine. Brief x-rays are taken to help direct the needle to the correct location. A small amount of local anesthetic and possibly steroid are slowly injected at the appropriate location.
- Radiofrequency lesioning/neurolytic procedures/rhizotomies. This procedure is done after diagnostic lumbar facet joint/medial branch blocks have correctly identified the location of your arthritic spinal pain. All nerves regenerate over time, so the results will not last forever; however, many patients experience pain relief that lasts six months to over a year. This procedure is performed in either the office or surgery center setting and typically takes about 20 – 30 minutes. A special needle is advanced to the target area under fluoroscopic (x-ray) guidance. A small amount of electrical current is then utilized to demonstrate proper placement along the targeted nerve. You will feel a buzz or tapping sensation, but it typically isn’t painful. Once the needle has been properly placed, a local anesthetic will be placed into the targeted area. The radiofrequency ablation, which typically lasts a few minutes, will then be performed. A combination of local anesthetic and steroids are injected before the needle is removed.