- Cervical spine is commonly affected in RA
- Following involvement is seen in decreasing order: Anterior atlontoaxial subluxation, atlantoaxial subluxation combined with subaxial Subluxation, Isolated subaxial subluxation, Superior migration of odontoid (a/k/a basilar invagination or vertical atlontoaxial instability
- Present with neck pain and paraesthesia / numbness in upper/lower extremities
- X rays are useful in identifying cervical spine changes
- Non operative management consists of early diagnosis of RA and followup with yearly x rays to rheumatologist, with or without cervical orthosis
- Operative treatment involves stabilization of involved segment
