[Involvement of the cervical spine in chronic juvenile arthritis. 29 cases followed for more than 5 years].

Analysis of cervical spine involvement is based on data from 29 cases of juvenile chronic arthritis (JCA), (8 systemic and 21 polyarticular forms). Follow-up is a least 5 years and exceeds 10 years in 17 cases. Among these 29 patients, 14 experienced cervical pain. One patient had Arnold neuralgia. No other neurologic complications were recorded. 14 of the 29 patients exhibited one or more roentgenological changes (3 of the 8 systemic patients and 11 of the 21 polyarticular patients). Of these, 4 never had any corresponding clinical symptoms. A chronologic correlation between onset of clinical and radiological signs was clearly established in only three cases. Among roentgenologic features, loss of physiologic lordosis was recorded in four patients. This finding was always associated with other radiologic changes. Seven patients had involvement of the posterior spine: blurred articular outlines and erosion of posterior epiphyses in one patient, fusion of neural arch joints involving C2-C3 in two patients and C2-C3 and C3-C4 in two others, and extensive fusion from C2 to C7 in two cases. Changes in the anterior spine were always accompanied with posterior lesions at the same level. Atlanto-axial or atlanto-occipital involvement was found in 9 of our 29 patients. Seven had forward slipping of C1 over C2. No instances of vertebral slipping below C1-C2 or of vertebral collapse were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)