Surgical Treatment of Rheumatoid Arthritis (RA)

• Uncontrollable pain combined with neurologic dysfunction

• Myelopathy from cervical spine instability

• Severe weakness resulting in functional disability

Procedures
Different surgical procedures are used to decompress the spinal cord. The goal in this surgery is to remove the offending tissue pressing on the spinal cord or neural elements. The surgeon makes recommendations based on many variables including the patient's condition.

Spinal instrumentation and fusion are surgical procedures that may be used to correct spinal deformity and to provide permanent stability to the spinal column. These procedures join and solidify the level where a spinal element has been damaged or removed.

Instrumentation utilizes medically designed hardware such as rods, bars, wires, and screws. These devices hold the spine straight during fusion. Fusion is the adhesive process joining bony spinal elements.

Recovery
Living with rheumatoid arthritis involves learning to adapt and making lifestyle changes that include a good diet, exercise, and rest.

• A physical therapy (PT) program can help restore muscle strength, flexibility, improve mobility, coordination, and maintain body functions through exercise. Massage, hydrotherapy, and other modalities can relieve pain. Gait training and use of assisted devices (e.g. cane, walker) can be taught to patients with difficulty walking.

• Occupational therapy (OT) teaches the patient how to cope with everyday life. OT encourages independence by helping the patient with daily tasks such as dressing, bathing, food preparation, going to the toilet, and other activities of daily living (ADLs).

• A personal medical diary can help keep track of doctor appointments, medications taken on a daily basis including supplements (vitamins, herbs), drugs that alleviated symptoms, side effects, and flare-ups and remissions.

It is important to keep follow-up appointments with the physician. Monitoring rheumatoid arthritis may include periodic blood tests, assessment of functional ability, pain status, and x-rays to evaluate possible disease progression.