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Topics · Must Know Facts · Spine

Rheumatoid spine

Must KnowSpinethinKbox SBA

Instability

AAI
Basilar invagination
Subaxial instability
Myelopathy
- pannus compression
- bony compression

Ranavat classification

I: Pain, no weakness
II: Subjective weakness
IIIA: Obj weakness, ambulatory
IIIB: Obj weakness, non ambulatory

Investigation

Xray, flexion extension
MRI

Management

Medical
Bracing
Surgery
- Progressive instability
- progressive neurology
- ADI > 10
- SAC <14

Surgery

Posterior
- C1-C2 fusion
- O-C2 fusion

Related FRCS concepts

Rheumatoid Cervical Spine Cervical spine approach Cervical Myelopathy Spine trauma T/L spine Clinical Examination of the Spine

Written/reviewed by Kishore Puthezhath

Professor of Orthopaedics and Consultant Paediatric Orthopaedic Surgeon

FRCS (Tr & Orth) revision resource

Reviewed: September 2026