Involvement of the cervical spine is a well-known complication of rheumatoid arthritis. Rheumatoid synovitis leads to ligamentous laxity and subsequent joint instability. Severe cervical spine deformities caused by rheumatoid arthritis may lead to serious complications, such as quadriparesis, cerebral infarction, chronic hydrocephalus, and even sudden death. We report surgical outcomes of two cases with rheumatoid arthritis characterized by severe myelopathy, and believe that surgical morbidity and mortality rates could be reduced with careful perioperative care, convenient anesthesia techniques, complete investigation for cervical spinal pathology, and proper surgical techniques. Surgical treatment can ensure satisfying improvements if adequate decompression and vertebral realignment could be achieved.

Keywords: Rheumatoid arthritis, cervical myelopathy, surgical treatment