Assessment of spine mobility in patients with ankylosing spondylitis by ultrasound scanning (preliminary data)

2021 ◽  
Vol 15 (6) ◽  
pp. 67-71
Author(s):  
M. K. Kurbanmagomedov ◽  
K. V. Sakharova ◽  
A. B. Demina ◽  
Sh. F. Erdes
Keyword(s):  
Lumbar Spine ◽  
Ankylosing Spondylitis ◽  
Negative Relationship ◽  
Analysis Data ◽  
Initial Position ◽  
Initial Examination ◽  
Limited Mobility ◽  
Spinous Processes ◽  
Spine Mobility ◽  
Spinal Ultrasound

Spine involvement in ankylosing spondylitis (AS) resulting in limited mobility requires a search for accurate, quantitatively methods of assessment of the decline of its function and monitoring of its dynamics. One of the promising methods for assessing movements in the spine in AS is ultrasound examination (US).Objective: to determine the relationship between the mobility of the spine measured sonographically, and the activity and functional status of patients with AS.Patients and methods. Spinal ultrasound was performed in 15 patients (10 men and 5 women, mean age 40.8±11.4 years, mean duration of the disease 5.5±3.5 years) with a confirmed diagnosis of AS, admitted to the V.A. Nasonova Research Institute of Rheumatology from April to August 2019. All patients underwent a double examination (at baseline and after 2 weeks) according to a specially developed protocol.Results and discussion. A comparative analysis of the results of sonographic measurements of the distance between the spinous processes of the vertebrae of the studied spine segment at baseline and after 2 weeks revealed a tendency towards an increase in these parameters both in the initial position and during flexion. There was no relationship between age, body mass index, duration of the disease and the distance between the spinous processes in all parts of the spine measured by sonography in initial position and during flexion. Correlation analysis data indicate the presence of a correlation between an increase in the distance between the spinous processes in the cervical and lumbar spine and a decrease in ESR, and i increase in the distance between the spinous processes in the lumbar spine and level of CRP. A weak negative relationship was found between the BASDAI index and the mobility of the spine at the LIV–V level and between sonographic measurements in all segment of the spine and the BASMI index.Conclusion. The sonographic method of determining the mobility of the spine can be recommended in patients with AS, both for initial examination and during follow-up, but it can't substitute the BASMI metrological index. Further research is needed to confirm the findings.

scholarly journals Lack of Association between Pulse Steroid Therapy and Bone Mineral Density in Patients with Multiple Sclerosis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Serap Zengin Karahan ◽  
Cavit Boz ◽  
Sevgi Kilic ◽  
Nuray Can Usta ◽  
Mehmet Ozmenoglu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Steroid Therapy ◽  
Negative Relationship ◽  
High Dose ◽  
Mineral Density ◽  
Factors Affecting

Multiple sclerosis (MS) has been associated with reduced bone mineral density (BMD). The purpose of this study was to determine the possible factors affecting BMD in patients with MS. We included consecutive 155 patients with MS and 90 age- and sex-matched control subjects. Patients with MS exhibited significantly lowerT-scores andZ-scores in the femoral neck and trochanter compared to the controls. Ninety-four (61%) patients had reduced bone mass in either the lumbar spine or the femoral neck; of these, 64 (41.3%) had osteopenia and 30 (19.4%) had osteoporosis. The main factors affecting BMD were disability, duration of MS, and smoking. There was a negative relationship between femoral BMD and EDSS and disease duration. No association with lumbar BMD was determined. There were no correlations between BMD at any anatomic region and cumulative corticosteroid dose. BMD is significantly lower in patients with MS than in healthy controls. Reduced BMD in MS is mainly associated with disability and duration of the disease. Short courses of high dose steroid therapy did not result in an obvious negative impact on BMD in the lumbar spine and femoral neck in patients with MS.

Validity and Reliability of the Metric Measurements in the Assessment of Lumbar Spine Motion in Patients With Ankylosing Spondylitis

Spine ◽  
2012 ◽  
Vol 37 (19) ◽  
pp. E1189-E1196 ◽  
Author(s):  
Aylin Rezvani ◽  
Onder Ergin ◽  
Ilhan Karacan ◽  
Mehmet Oncu
Keyword(s):  
Lumbar Spine ◽  
Ankylosing Spondylitis ◽  
Validity And Reliability ◽  
Spine Motion

Development of lumbar spine mobility in humans aged 3–25 years

2013 ◽  
Vol 38 ◽  
pp. S106
Author(s):  
Jacek Lewandowski ◽  
Małgorzata B. Ogurkowska
Keyword(s):  
Lumbar Spine ◽  
Spine Mobility

Preliminary tests of an Inertial Measurement Units based System for Spine mobility assessment in patients with Ankylosing Spondylitis

2021 ◽  
Author(s):  
Adriana Martinez-Hernandez ◽  
Miguel A. Padilla-Castaneda ◽  
Juan Salvador Perez Lomeli ◽  
Julio Casasola-Vargas ◽  
Ruben Burgos-Vargas
Keyword(s):  
Ankylosing Spondylitis ◽  
Inertial Measurement Units ◽  
Inertial Measurement ◽  
Mobility Assessment ◽  
Spine Mobility ◽  
Measurement Units

THU0387 THE IMPACT OF TREATMENT WITH A BIOLOGICAL DISEASE-MODIFYING ANTIRHEUMATIC DRUG ON SPINAL MOBILITY AND ITS CORRELATION WITH DISEASE ACTIVITY IN PATIENTS WITH SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 428.1-428
Author(s):  
S. Garcia ◽  
B. M. Fernandes ◽  
S. Ganhão ◽  
M. Rato ◽  
F. Pinheiro ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Tumor Necrosis Factor Inhibitor ◽  
Spinal Mobility ◽  
Reference Level ◽  
National Database ◽  
Interleukin 17 ◽  
Spine Mobility ◽  
Disease Modifying ◽  
The Impact

Background:Bath Ankylosing Spondylitis Metrology Index (BASMI) is an instrument developed to assess spinal and hip mobility. The relationship between BASMI and disease activity is not always linear and, above all, the data that correlate the variation in BASMI values (ΔBASMI) with the variation in disease activity scores and response to treatment are not unanimous.Objectives:Explore the effect of biological disease-modifying antirheumatic drugs (bDMARD) in spine mobility (as assessed by BASMI) and the associations between ΔBASMI and disease activity.Methods:Observational retrospective study was performed including consecutive patients with the diagnosis of Spondyloarthritis (SpA) followed at our Rheumatology Department. Demographic, clinical, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), BASMI, Ankylosing Spondylitis Disease Activity Score with erythrocyte sedimentation rate and C-reactive protein (ASDAS ESR and ASDAS CRP, respectively), and laboratorial data were collected from our national database at baseline, 6 and 12 months after initiation of a bDMARD. The variation of each parameter was calculated as the difference between the levels recorded at 6 and 12 months and the reference level and presented in the form of Δ. Statistical analysis was performed using SPSS 23.0. Correlations between variables were studied using Spearman correlation analysis and comparison between groups was performed using Wilcoxon and Kruskal-Wallis tests.Results:Median age of patients (n=178) was 42 years old [34, 50], 92 (51.7%) were males with a median disease duration of 4.9 [1.0, 10.3] years. One hundred and twenty-six patients (70.8%) had Ankylosing Spondylitis, 15 (8.4%) Inflammatory Bowel Disease related SPA and 30 (16.9%) Undifferentiated SpA. Fifty four (30.3%) patients were taking glucocorticoids and regarding conventional synthetic disease-modifying anti-rheumatic drugs use before starting the bDMARD: Sulfasalazine (52, 29.2%), Methotrexate (31, 17.4%) and Leflunomide (3, 1.7%). Regarding the bDMARD, only one patient started Secukinumab and the others a Tumor necrosis factor inhibitor (TNFi) [Golimumab (n= 64, 36.0%), Adalimumab (n=36, 20.2%), Infliximab (n= 35, 19.7%), Etanercept (n= 32, 18.0%) and Certolizumab (n= 10, 5.6%)].The majority of the patients had very high disease activity at baseline (86.0%, n=153); median ESR was 29 mm/h [15, 47], median CRP was 13.7 mg/L, [6.60, 27.3], median ASDAS CRP was 7.6 [6.0, 9.0] and median BASMI was 8.0 [7-0, 9.0]. After 6 and 12 months of treatment, mean ESR, CRP, ASDAS-CRP and BASMI were significantly lower than mean baseline values (p<0.01), with median ASDAS-CRP at 12 months of 2.20 [1.50, 2.90] and median ΔBASMI of -4.10 [-5.50, -2.40].BASMI at baseline showed a moderate correlation with ASDAS CRP (r=0.468, p<0.01), BASDAI (r=0.496, p<0.01) and patient visual analogic scale (VAS) (r=0.563, p<0.01). No correlations were found between BASMI and CRP, ESR, physician VAS or the consumption of nonsteroidal anti inflammatory drugs at baseline.A significant positive correlation was found between ΔBASMI and ΔASDAS at 6 months and 12 months (r=0.243, p=0.02; r=0.286; p<0.01) and also between ΔBASMI and ΔBASDAI at 6 and 12 months (r=0.183, p=0.04; r=0.291, p=0.02). No correlations were found between ΔBASMI and ΔCRP or ΔESR. No differences were observed in ΔBASMI, regarding the bDMARD of choice.Conclusion:In our cohort, starting a bDMARD improved BASMI scores through a 12 month period and there was a correlation between the variation of BASMI and disease activity improvement. As such, a TNFi may retard the progression of spinal mobility dysfunction in SpA patients. We cannot draw conclusions regarding differences between TNFi and interleukin 17 inhibitors and further work is needed to clarify possible differences in their impact in improving spine mobility.Disclosure of Interests:Salomé Garcia: None declared, Bruno Miguel Fernandes: None declared, Sara Ganhão: None declared, Maria Rato: None declared, Filipe Pinheiro: None declared, Georgina Terroso: None declared, Miguel Bernardes Speakers bureau: Abbvie, Amgen, Biogen, Eli-Lilly, Glaxo-Smith-Kline, Pfizer, Janssen, Novartis, Lúcia Costa: None declared

Palpation identification of spinous processes in the lumbar spine

2007 ◽  
Vol 12 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Joanne C. Harlick ◽  
Stephan Milosavljevic ◽  
Peter D. Milburn
Keyword(s):  
Lumbar Spine ◽  
Spinous Processes

scholarly journals Assessment of Subclinical Vascular Disease Associated with Ankylosing Spondylitis

2011 ◽  
Vol 38 (4) ◽  
pp. 723-729 ◽  
Author(s):  
NÓRA BODNÁR ◽  
GYÖRGY KEREKES ◽  
ILDIKÓ SERES ◽  
GYÖRGY PARAGH ◽  
JÁNOS KAPPELMAYER ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Vascular Disease ◽  
Aortic Stiffness ◽  
Disease Duration ◽  
Activity Index ◽  
Disease Activity Index ◽  
Intima Media Thickness ◽  
Diagnostic Tools ◽  
Spine Mobility

Objective.Studies indicate that ankylosing spondylitis (AS), as well as rheumatoid arthritis, may be associated with accelerated atherosclerosis and vascular disease. We assessed endothelial dysfunction, carotid atherosclerosis, and aortic stiffness in AS in context with clinical and laboratory measurements.Methods.Forty-three patients with AS and 40 matched healthy controls were studied. We assessed common carotid intima-media thickness (ccIMT), flow-mediated vasodilation (FMD), and pulse-wave velocity (PWV) in association with age, disease duration, smoking habits, body mass index, patient’s assessment of pain and disease activity, Bath AS Disease Activity Index, Bath AS Functional Index (BASFI), metric measurements, erythrocyte sedimentation rate, C-reactive protein, and HLA-B27 status.Results.We found impaired FMD (6.85 ± 2.98% vs 8.30 ± 3.96%; p = 0.005), increased ccIMT (0.65 ± 0.15 vs 0.54 ± 0.15 mm; p = 0.01), and higher PWV (8.64 ± 2.44 vs 8.00 ± 1.46 m/s; p = 0.03) in patients with AS compared to controls, respectively. We also found that ccIMT negatively correlated with FMD (r = −0.563; p = 0.0001) and positively correlated with PWV (r = 0.374; p = 0.018). Both ccIMT and PWV correlated with disease duration (r = 0.559; p = 0.013 and r = 0.520; p = 0.022, respectively), BASFI (r = 0.691; p = 0.003 and r = 0.654; p = 0.006), decreased lumbar spine mobility (r = −0.656; p = 0.006 and r = −0.604; p = 0.013), chest expansion (r = −0.502; p = 0.047 and r = −0.613; p = 0.012), and increased wall-occiput distance (r = 0.509; p = 0.044 and r = 0.614; p = 0.011).Conclusion.In this well characterized AS population, impaired FMD and increased ccIMT and PWV indicate abnormal endothelial function and increased atherosclerosis and aortic stiffness, respectively. The value of noninvasive diagnostic tools needs to be further characterized.

Transpedicular Bivertebrae Wedge Osteotomy and Discectomy in Lumbar Spine for Severe Ankylosing Spondylitis

2010 ◽  
Vol 23 (3) ◽  
pp. 186-191 ◽  
Author(s):  
Yan Wang ◽  
YongGang Zhang ◽  
KeYa Mao ◽  
XueSong Zhang ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Ankylosing Spondylitis ◽  
Wedge Osteotomy

Involvement of the proximal tibiofibular joint in ankylosing spondylitis

2009 ◽  
Vol 50 (4) ◽  
pp. 418-422 ◽  
Author(s):  
Hyun Pyo Hong ◽  
Hye Won Chung ◽  
Byeong-Kyoo Choi ◽  
Young Cheol Yoon ◽  
Sang Hee Choi
Keyword(s):  
Bone Marrow ◽  
Lumbar Spine ◽  
Ankylosing Spondylitis ◽  
Signal Intensity ◽  
Proximal Tibiofibular Joint ◽  
Plain Radiographs ◽  
Bone Marrow Signal ◽  
Abnormal Bone Marrow ◽  
Marrow Signal ◽  
Subchondral Sclerosis

Background: Ankylosing spondylitis (AS) may affect peripheral joints, with the shoulder, hip, and knee being well known involved sites. However, involvement of the proximal tibiofibular (PTF) joint has not yet been investigated. Purpose: To evaluate PTF joint abnormalities in patients with AS. Material and Methods: From July 1997 to June 2005, 16 patients (15 male, one female; mean age 25 years), who were clinically diagnosed with AS, underwent magnetic resonance imaging (MRI) to evaluate knee pain. All patients also underwent plain radiographs of the knee, lumbar spine, and pelvis. Twenty knee MRIs (bilateral in four patients) and 16 sets of knee, lumbar spine, and pelvic radiographs were retrospectively reviewed in order to evaluate possible AS involvement. The presence of abnormalities suggesting AS involvement were recorded separately in the sacroiliac joints, lumbar spine, hip, and femorotibial and PTF joints. If the PTF joint showed any pathologic findings, the radiologic findings were recorded. Results: Three of 16 patients (18.7%) had pathologic features of the PTF joint observed by plain radiographs or MRI. One of these three patients showed bilateral involvement of the PTF joints on plain radiographs, while the other two patients showed unilateral involvement on MRI. Subchondral sclerosis, cartilage abnormality, erosion, and abnormal bone marrow signal intensity were identified on MRI. Plain radiographs of two patients revealed subchondral sclerosis and spur formation in the PTF joint. The frequencies of involvement of other joints in the 16 patients were as follows: lumbar spine, n=5 (31%), hip joint, n=1 (6%) (identified by plain radiographs), and femorotibial joints, n=10 (62.5%) (identified by knee MRI). Conclusion: MR imaging of the PTF joint can depict synovial changes and their effect on joint structures in patients with AS. The MRI findings of AS involving the PTF joints are subchondral sclerosis, cartilage abnormality, erosion, and abnormal bone marrow signal intensity.

scholarly journals Fluoroscopically-Guided Injections to Treat “Kissing Spine” Disease

2008 ◽  
Vol 4;11 (8;4) ◽  
pp. 549-554 ◽  
Author(s):  
Tim Lamer
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Soft Tissues ◽  
Nerve Fibers ◽  
Low Back ◽  
Mri Findings ◽  
Mri Features ◽  
Spinous Processes ◽  
Spine Disease

Background: Any spine structure that is innervated by afferent nociceptive nerve fibers is a potential pain generator. In the lumbar spine, the most studied pain generators include: sacroiliac joints, the zygapophysial joints, the intervertebral discs, myofascial structures. Anomalous lumbosacral articulations, the spinous processes, and lumbar spine osteophytes are less commonly reported. Objective: To describe the diagnostic and therapeutic features of “kissing spine” disease or Baastrup’s Sign with particular attention to MRI findings and fluoroscopicallyguided injection therapy. Design: A series of 3 patients with axial low back pain presented with exam findings and MRI changes suggestive of pain emanating from adjacent spinous processes that appeared to be in direct contact or very closely opposed. This has been described in the literature as “kissing spine” disease or Baastrup’s sign. Fluoroscopically-guided injections were performed and the responses were studied. Results: The 3 patients had MRI findings consisting of inflammation and/or edema in the spinous processes and surrounding soft tissues. Fluoroscopically-guided injections provided pain relief in all 3 patients. One patient with recurrent pain eventually underwent successful surgical resection of the involved spinous processes. Conclusion: Painful adjacent and closely opposed spinous processes can be a source of axial low back pain. We have described MRI features and the responses to fluoroscopically-guided injections in 3 patients with this condition. Key words: Baastrup’s, kissing spine, spine injection

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