Risk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery: a retrospective study
Abstract Objectives The effect of biologics on cervical spine lesions (CSLs) and vital prognosis in patients with rheumatoid arthritis (RA) remains unclear. This study investigated the risk factors for a poor vital prognosis in patients with RA requiring primary cervical spine surgery for CSLs. Meth...
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BMC
2025-07-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13075-025-03593-w |
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| author | Takafumi Kuramoto Koji Sakuraba Kazuhiro Kai Kazumasa Terada Nobuo Kobara Hirofumi Bekki Jun-ichi Fukushi |
| author_facet | Takafumi Kuramoto Koji Sakuraba Kazuhiro Kai Kazumasa Terada Nobuo Kobara Hirofumi Bekki Jun-ichi Fukushi |
| author_sort | Takafumi Kuramoto |
| collection | DOAJ |
| description | Abstract Objectives The effect of biologics on cervical spine lesions (CSLs) and vital prognosis in patients with rheumatoid arthritis (RA) remains unclear. This study investigated the risk factors for a poor vital prognosis in patients with RA requiring primary cervical spine surgery for CSLs. Methods We retrospectively investigated 139 patients with RA who underwent primary cervical spine surgery between January 2001 and December 2020. The vital prognosis was calculated using the Kaplan–Meier method. Patient data were collected from medical records to analyse the risk factors for vital prognosis using univariate and multivariate Cox regression analyses. Results The vital prognosis was 62.7% at 10 years according to the Kaplan–Meier method. In univariate analysis, advanced age, lower serum albumin levels, high-dose prednisolone administration, non-use of methotrexate, and subaxial subluxation (SAS) comorbidity were significantly associated with a high risk of mortality. In multivariate analysis, advanced age, lower serum albumin levels, high-dose prednisolone administration, and SAS comorbidity were identified as risk factors for a poor vital prognosis. Conclusions SAS comorbidity, high-dose prednisolone administration, lower serum albumin levels, and advanced age exacerbate the vital prognosis in patients with RA requiring primary cervical spine surgery. Strict disease control aimed at preventing CSL progression to SAS by maintaining the nutritional status and without using steroids is necessary to improve the vital prognosis of patients with RA. |
| format | Article |
| id | doaj-art-76d6439a46fc43ed9f58b2895c34a06e |
| institution | Kabale University |
| issn | 1478-6362 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj-art-76d6439a46fc43ed9f58b2895c34a06e2025-08-20T04:01:35ZengBMCArthritis Research & Therapy1478-63622025-07-012711910.1186/s13075-025-03593-wRisk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery: a retrospective studyTakafumi Kuramoto0Koji Sakuraba1Kazuhiro Kai2Kazumasa Terada3Nobuo Kobara4Hirofumi Bekki5Jun-ichi Fukushi6Clinical Research Center, NHO Kyushu Medical CenterClinical Research Center, NHO Kyushu Medical CenterClinical Research Center, NHO Kyushu Medical CenterClinical Research Center, NHO Kyushu Medical CenterDepartment of Orthopaedic Surgery and Rheumatology, NHO Kyushu Medical CenterClinical Research Center, NHO Kyushu Medical CenterClinical Research Center, NHO Kyushu Medical CenterAbstract Objectives The effect of biologics on cervical spine lesions (CSLs) and vital prognosis in patients with rheumatoid arthritis (RA) remains unclear. This study investigated the risk factors for a poor vital prognosis in patients with RA requiring primary cervical spine surgery for CSLs. Methods We retrospectively investigated 139 patients with RA who underwent primary cervical spine surgery between January 2001 and December 2020. The vital prognosis was calculated using the Kaplan–Meier method. Patient data were collected from medical records to analyse the risk factors for vital prognosis using univariate and multivariate Cox regression analyses. Results The vital prognosis was 62.7% at 10 years according to the Kaplan–Meier method. In univariate analysis, advanced age, lower serum albumin levels, high-dose prednisolone administration, non-use of methotrexate, and subaxial subluxation (SAS) comorbidity were significantly associated with a high risk of mortality. In multivariate analysis, advanced age, lower serum albumin levels, high-dose prednisolone administration, and SAS comorbidity were identified as risk factors for a poor vital prognosis. Conclusions SAS comorbidity, high-dose prednisolone administration, lower serum albumin levels, and advanced age exacerbate the vital prognosis in patients with RA requiring primary cervical spine surgery. Strict disease control aimed at preventing CSL progression to SAS by maintaining the nutritional status and without using steroids is necessary to improve the vital prognosis of patients with RA.https://doi.org/10.1186/s13075-025-03593-wRheumatoid arthritisCervical spine lesionVital prognosisSubaxial subluxationPrednisolone |
| spellingShingle | Takafumi Kuramoto Koji Sakuraba Kazuhiro Kai Kazumasa Terada Nobuo Kobara Hirofumi Bekki Jun-ichi Fukushi Risk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery: a retrospective study Arthritis Research & Therapy Rheumatoid arthritis Cervical spine lesion Vital prognosis Subaxial subluxation Prednisolone |
| title | Risk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery: a retrospective study |
| title_full | Risk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery: a retrospective study |
| title_fullStr | Risk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery: a retrospective study |
| title_full_unstemmed | Risk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery: a retrospective study |
| title_short | Risk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery: a retrospective study |
| title_sort | risk factors affecting the vital prognosis in patients with rheumatoid arthritis after primary cervical spine surgery a retrospective study |
| topic | Rheumatoid arthritis Cervical spine lesion Vital prognosis Subaxial subluxation Prednisolone |
| url | https://doi.org/10.1186/s13075-025-03593-w |
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