In patients with inflammatory arthritis the immune system "perceives" the cartilage of the spinal (facet) joints as a foreign substance. The synovium, a thin layer of tissue which surrounds the joint and which secretes a lubricating fluid that delivers nutrients to the cartilage, becomes inflamed and thickened. The immune mediated inflammatory response which follows, causes the joint cartilage to breakdown (erode), resulting in pain, stiffness, and progressive destruction of the joint. The following represents a list of various forms of inflammatory arthritis all of which can afflict the spine. Each has a characteristic clinical and laboratory presentation.

• Rheumatoid arthritis
• Juvenile rheumatoid arthritis
• Psoriatic arthritis
• Ankylosing Spondylitis
• Reactive arthritis
• Lupus erythematosus
• Lyme disease

In inflammatory disorders, problems develop due to an overreaction of the immune system, and through the release of various signaling chemicals. An autoimmune disorder causes an individuals immune system to become activated (stimulated) against proteins normally found in the body. The body essentially launches an attack on some of its own cells. The autoimmune response may be limited to certain organs or tissues. The presence of autoimmune disease may increase the risk for surgical graft or surgically implanted instrumentation rejection. Autoimmune disorders may be associated with inflammation of certain tissues of the spine.