Expert’s comment concerning Grand Rounds case entitled “Rheumatoid arthritis-associated spinal neuroarthropathy with double-level isthmic spondylolisthesis” by S. I. Kim et al. (Eur Spine J; 2017: doi:10.1007/s00586-017-5220-6)

[摘要] I congratulate the authors for presenting this interesting case of dual pathology. This patient with a background of rheumatoid arthritis initially presented with mild low back pain and was found to have L4 and L5 spondylolysis with minimal spondylolisthesis (slip) [1]. Over the following years the extent of the slip gradually increased, but her symptoms remained minimal until 8 years later when her back pain worsened and she also developed radicular pain. Imaging at this stage showed marked progression of the slip at both levels with accompanying destructive change, and she also had signs of progression of her rheumatoid disease in her wrists and cervical spine.