Degenerative changes of lumbar spine and their clinical implications in patients with axial spondyloarthritis
Yükleniyor...
Tarih
2022
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Springer
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
The objective of this study was to assess degenerative changes (DCs) on magnetic resonance imaging (MRI) of lumbar spine in axial spondyloarthritis (axSpA) and non-specifc mechanical low back pain (mLBP). Patients were consecutively recruited and all underwent MRI of the lumbar spine in this cross-sectional study. Disk degeneration (DD, Pfrrmann classifcation), endplate changes (Modic, types 1, 2, and 3), annular fssure, disk bulging, and protrusion or extrusion at each lumbar spinal level were assessed using anonymized images. Patients with axSpA were assessed for disease activity, functioning, and quality of life. Univariate and subsequent multivariate logistic regression analyses with adjustments of various covariates were used to assess association between MRI fndings and clinical variables. One hundred twenty-three patients had non-radiographic (nr-axSpA) and 144 had radiographic axSpA/ankylosing spondylitis (AS). Degenerative changes were more prevalent in patients with mLBP (n=105) than axSpA. Disk degeneration was the most prevalent MRI fnding, followed by annular fssure, disk herniation (protrusion or extrusion), and Modic changes (MCs) in axSpA. Disk herniation was more prevalent in patients with nr-axSpA compared to AS. Modic changes (OR=6.455), lumbar disk herniation (OR=2.278), annular fssure (OR=2.842), conventional synthetic or biologic disease-modifying antirheumatic drugs (csDMARDs) non-users (OR=2.225), and advanced age (OR=31.556) were factors associated with an increased risk of DD in axSpA. Coexisting * Gamze Kilic gkilic.md@hotmail.com 1 Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Karadeniz Technical University, Trabzon, Turkey 2 Department of Radiology, Sevgi Hospital, Kayseri, Turkey 3 Department of Physical Medicine and Rehabilitation, Ministry of Health Kayseri City Hospital, Kayseri, Turkey 4 Department of Rheumatology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey 5 Department of Rheumatology, Gaziosmanpasa Hospital, Istinye University, Istanbul, Turkey 6 Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Trakya University, Edirne, Turkey DD increased the burden of disease in axSpA. A considerable proportion of patients with axSpA had DD at the lumbar spine. These degenerative changes might explain some of the complaints and should not been overlooked in patients with axSpA.
Açıklama
Key Points
• Lumbar herniated nucleus pulposus (LHNP) is more frequent in nr-axSpA while MC is more frequent in AS.
• DD may cause an increase in BASFI and BASMI scores in axSpA.
• Spinal DCs might be an alternative explanation for low back complaints and should not been overlooked in patients with axSpA
Anahtar Kelimeler
Ankylosing Spondylitis, Low Back Pain, Magnetic Resonance Imaging
Kaynak
Clinical Rheumatology
WoS Q Değeri
Q3
Scopus Q Değeri
Q2
Cilt
Sayı
Künye
Kilic G, Senol S, Baspinar S, Kilic E, Ozgocmen S. Degenerative changes of lumbar spine and their clinical implications in patients with axial spondyloarthritis. Clin Rheumatol. 2022 Aug 3. doi: 10.1007/s10067-022-06321-w. Epub ahead of print. PMID: 35922576.
