Postoperative outcomes after cervical spine surgery in rheumatoid arthritis patients: a multicenter cohort study.
11 affiliations
- 1Department of Orthopaedic Surgery and Spinal Surgery, The University of Tokyo, Tokyo, Japan.
- 2University of Tokyo Spine Group (UTSG), Tokyo, Japan.
- 3Department of Spine and Orthopedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
- 4Department of Orthopedic Surgery, Kanto Rosai Hospital, Kawasaki, Japan.
- 5Department of Orthopedic Surgery, Japanese Red Cross Musashino Hospital, Musashino, Japan.
- 6Department of Spinal Surgery, Japan Community Health-Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan.
- 7Department of Orthopedic Surgery, Yokohama Rosai Hospital, Yokohama, Japan.
- 8Spine Center, Toranomon Hospital, Tokyo, Japan.
- 9Department of Orthopedic Surgery, Japanese Red Cross Saitama Hospital, Saitama, Japan.
- 10Department of Orthopedic Surgery, Inanami Spine and Joint Hospital, Tokyo, Japan.
- 11Department of Orthopedic Surgery, Sagamihara National Hospital, Sagamihara, Japan.
Abstract
There is a lack of comparative studies examining patient-reported outcomes (PROs) after cervical spine surgery between rheumatoid arthritis (RA) and non-RA patients. The objective of this study was to compare postoperative outcomes after cervical spine surgery between RA and non-RA patients. This retrospective cohort study utilized prospectively registered data from patients older than 18 years who underwent primary cervical spine surgery from April 2017 to March 2022 at 13 institutions in the Greater Tokyo metropolitan area. Demographics, perioperative complications, surgical details, and PROs were recorded. Propensity-score overlap weighting was used to adjust for baseline and surgical differences between RA and non-RA groups, and group differences were reported with 95% confidence intervals. In this cohort of 2,729 participants, 2.5% (67 individuals) were diagnosed with RA. These RA patients were predominantly older women with lower body mass index and more frequently required upper cervical or fusion surgery. The average duration of RA was 21 years, with treatment involving steroids in 56.7%, methotrexate in 41.8%, and biologics in 19.4%. After overlap weighting, RA patients had poorer preoperative and postoperative PROs than non-RA patients. However, RA patients showed improvements in several symptoms and quality-of-life measures. The overlap-weighted improvement in EQ-5D was 0.14 in RA patients and 0.13 in non-RA patients [difference, 0.01; 95% confidence interval (CI): -0.06 to 0.09]. The Neck Disability Index (NDI) showed only limited improvement in RA patients, whereas postoperative satisfaction was not clearly lower in RA patients. Patients with RA had poorer PROs before and after cervical spine surgery than non-RA patients. Nevertheless, selected RA patients showed improvement in several symptoms and quality-of-life measures, and postoperative satisfaction was not clearly lower. Disability measured by the NDI may remain less responsive, and the limited number of RA patients and wide confidence intervals preclude any conclusion of equivalence with non-RA patients.
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BibTeX
@article{oshima2026postoperative,
title = {{Postoperative outcomes after cervical spine surgery in rheumatoid arthritis patients: a multicenter cohort study.}},
author = {Yasushi Oshima and Hiroyasu Kodama and Yudai Kumanomido and Michita Noma and Yuko Yagi and Naohiro Kawamura and Yukimasa Yamato and Tomomi Sunayama and Akiro Higashikawa and Naoto Komatsu and Nobuhiro Hara and Takashi Ono and Ryoko Onodera and Yujiro Takeshita and Masayoshi Fukushima and Naoki Okamoto and Katsuyuki Sasaki and Yuichi Yoshida and So Kato and Yuki Taniguchi and Sakae Tanaka},
journal = {Journal of spine surgery (Hong Kong)},
year = {2026},
month = sep,
doi = {10.21037/jss-2026-0149},
url = {https://europepmc.org/article/MED/42996638},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Postoperative outcomes after cervical spine surgery in rheumatoid arthritis patients: a multicenter cohort study.
AU - Yasushi Oshima
AU - Hiroyasu Kodama
AU - Yudai Kumanomido
AU - Michita Noma
AU - Yuko Yagi
AU - Naohiro Kawamura
AU - Yukimasa Yamato
AU - Tomomi Sunayama
AU - Akiro Higashikawa
AU - Naoto Komatsu
AU - Nobuhiro Hara
AU - Takashi Ono
AU - Ryoko Onodera
AU - Yujiro Takeshita
AU - Masayoshi Fukushima
AU - Naoki Okamoto
AU - Katsuyuki Sasaki
AU - Yuichi Yoshida
AU - So Kato
AU - Yuki Taniguchi
AU - Sakae Tanaka
PY - 2026
DA - 2026/09/29
JO - Journal of spine surgery (Hong Kong)
DO - 10.21037/jss-2026-0149
UR - https://europepmc.org/article/MED/42996638
AB - There is a lack of comparative studies examining patient-reported outcomes (PROs) after cervical spine surgery between rheumatoid arthritis (RA) and non-RA patients. The objective of this study was to compare postoperative outcomes after cervical spine surgery between RA and non-RA patients. This retrospective cohort study utilized prospectively registered data from patients older than 18 years who underwent primary cervical spine surgery from April 2017 to March 2022 at 13 institutions in the Greater Tokyo metropolitan area. Demographics, perioperative complications, surgical details, and PROs were recorded. Propensity-score overlap weighting was used to adjust for baseline and surgical differences between RA and non-RA groups, and group differences were reported with 95% confidence intervals. In this cohort of 2,729 participants, 2.5% (67 individuals) were diagnosed with RA. These RA patients were predominantly older women with lower body mass index and more frequently required upper cervical or fusion surgery. The average duration of RA was 21 years, with treatment involving steroids in 56.7%, methotrexate in 41.8%, and biologics in 19.4%. After overlap weighting, RA patients had poorer preoperative and postoperative PROs than non-RA patients. However, RA patients showed improvements in several symptoms and quality-of-life measures. The overlap-weighted improvement in EQ-5D was 0.14 in RA patients and 0.13 in non-RA patients [difference, 0.01; 95% confidence interval (CI): -0.06 to 0.09]. The Neck Disability Index (NDI) showed only limited improvement in RA patients, whereas postoperative satisfaction was not clearly lower in RA patients. Patients with RA had poorer PROs before and after cervical spine surgery than non-RA patients. Nevertheless, selected RA patients showed improvement in several symptoms and quality-of-life measures, and postoperative satisfaction was not clearly lower. Disability measured by the NDI may remain less responsive, and the limited number of RA patients and wide confidence intervals preclude any conclusion of equivalence with non-RA patients.
SN - 2414-469X
SN - 2414-4630
ER -