Cervical spine complications in rheumatoid arthritis patients. Awareness is the key to averting serious consequences.

Rheumatoid arthritis is associated with several pathologic changes in the cervical spine, including loss of articular cartilage, ligamentous destruction, and bone erosion. These changes may lead to one or a combination of complications, including atlantoaxial subluxation, cranial settling, subaxial cervical subluxation, and periodontoid pannus formation. Surgical management of these problems should focus on relieving pain, stabilizing the spine, and decompressing neural elements.