In his latest installment to the Total Spine series of instructional videos, Dr. Paul McCormick describes retropleural thoracotomy, a surgical technique used to treat complex spinal conditions of the thoracic and lumbar spine. “Retropleural thoracotomy is an important...
Rheumatoid = inflammation and pain in joints, muscles, or soft tissue
Rheumatoid arthritis (RA) is a disease that causes painful and stiff joints. RA can affect any joint in the body. At The Spine Hospital at The Neurological Institute of New York, we specialize in treating RA of the spine.
RA is an autoimmune disorder, which means the damage is caused when the immune system mistakenly attacks healthy tissue. RA differs from osteoarthritis in that osteoarthritis (often just called “arthritis”) results from wear and tear on the joints.
RA may start in one part of the body and progress to others. There is not a universal pattern as to how the disease progresses, what joints will be affected, and the severity of the involvement of each joint.
When RA affects the spine, it is more common for the cervical spine (neck) to be affected than other portions of the spine. RA can affect the cervical spine as early as the first two years of the disease’s onset. Sometimes it affects the spine much later, and sometimes it never involves the spine at all.
RA in the spine can cause the following symptoms:
In progressive forms of RA, the deterioration of the joints in the spine can result in the spinal cord and/or spinal nerve roots becoming compressed (pinched). The symptoms of compression vary depending on the portion of the spine that is affected. These symptoms may include:
Patients with severe RA typically have multiple affected joints in the hands, arms, legs, and feet. Inflammation of the eyes, mouth and lungs can also develop.
|Causes and Risk Factors|
Although the cause is unknown, it is suspected genes and environment play a role in developing RA.
There is research to support the involvement of certain genes, called HLA class II genes, in the development of RA.
Environmental factors may include smoking, exposure to certain bacteria or viruses.
RA can affect anyone, but it is more common in women. It usually presents in middle age and is most common in older people.
|Tests and Diagnosis|
A physician may perform the following tests to confirm the diagnosis of RA:
Although there is no cure, there are many treatments available to help reduce symptoms of RA.
A doctor may prescribe the following medications to provide relief of symptoms and improve joint function in the spine:
In rare cases, surgery may be required when RA has greatly affected the joints in the spine. If the deterioration of the joints in the spine has led to compression of the spinal cord or instability of the spine, the goal of surgical intervention is to decompress the spinal cord and stabilize the spine. The surgeon may perform a laminectomy to remove the lamina, which is the bone that covers the spinal canal. Removing the lamina makes room for the spinal cord. In some cases, the surgeon may perform a spinal fusion to ensure the spinal column is stable after surgery. During a spinal fusion, the surgeon may place new bone and allow the bones to fuse together (fusion).
The doctor will discuss the available treatment options and will tailor the treatment to each patient and situation.
|Preparing for Your Appointment|
Drs. Paul C. McCormick, Michael G. Kaiser, Alfred T. Ogden, Christopher E. Mandigo and Patrick C. Reid at The Spine Hospital at The Neurological Institute of New York are experts in treating rheumatoid arthritis. They can also offer you a second opinion.
Helpful Surgery Overviews
Dr. McCormick will choose the treatment method specific to each patient and situation. Some of the condition’s treatment options may be listed below.
As a public service to its readers, New York Magazine annually publishes its roster of Best Doctors, arranged by specialty, from communities in the New York City metropolitan area. For the 16th year in a row, Dr. Paul C. McCormick has made this prestigious list in the...
Dr. Paul McCormick Once Again Invited to Speak Before International Gathering of Spinal Neurosurgeons
Lifelong learning is an essential aspect of spinal neurosurgery. Indeed, the top spinal neurosurgeons keep avidly up to date with the frontiers of their field, while also achieving an unprecedented depth of knowledge in their field. Dr. Paul McCormick is exactly that...