Comparison of sagittal lumbosacral parameters in patients with ankylosing spondylitis and chronic mechanical back pain

Comparison of sagittal lumbosacral parameters in patients with ankylosing spondylitis and chronic mechanical back pain

Aim: Lumbosacral parameters can be affected in ankylosing spondylitis (AS) and chronic mechanical back pain.We compared lumbosacral parameters between patients with AS and chronic mechanical back pain to identify specific changes in AS.Material and Methods:This study has a retrospective design. A total of 42 patients with AS (16 females, 26 males) and 66 patients with chronic mechanical back pain (31 females, 35 males) were enrolled in the study. Lumbar lordosis angle (LLA), lumbosacral angle (LSA), sacral tilt (ST), and lumbosacral disc angle (LSDA) were measured using digitalized standing lateral lumbar radiographs. CRP and ESR concentrations of AS patients were obtained from the hospital database.Results: LLA, LSA, ST and LSDA were significantly smaller in the patients with AS (p < 0.05).CRP and ESR were significantly and negatively correlated with LLA and LSA (r = -0.516, p < 0.001; r = -0.401, p = 0.009 for CRP and r = -0.623, p < 0.001; r = -0.474, p = 0.002 for ESR). In AS patients, LLA was significantly and positively correlated with LSA and ST (r = 0.490, p = 0.001; r = 0.399, p = 0.009). Additionally, LSA was significantly and positively correlated with LSDA (r = 0.613, p < 0.001).Conclusion: The sagittal lumbosacral parameters of patients with AS were found to be significantly different from those of patients with chronic mechanical back pain. İnflammation negatively affects lumbosacral alignment in AS. The identification of specific changes in sagittal spinal alignment in patients with AS will contribute to the establishment of appropriate rehabilitation strategies and surgical plans

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  • 1. Dougados M, Baeten D. Spondyloarthritis. Lancet 2011;377:2127-37.
  • 2. Elewaut D, Matucci-Cerinic M. Treatment of ankylosing spondylitis and extra-articular manifestations in everyday rheumatology practice. Rheumatology (Oxford) 2009;48:1029-35.
  • 3. Sawacha Z, Carraro E, Del Din S, et al. Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis. J Neuroeng Rehabil 2012;9:63.
  • 4. White AA 3rd, Panjabi MM, Thomas CL. The clinical biomechanics of kyphotic deformities. Clin Orthop Relat Res 1977;128:8-17.
  • 5. Coskun Benlidayi I, Basaran S. Comparative study of lumbosacral alignment in elderly versus young adults: data on patients with low back pain. Aging Clin Exp Res 2015;27:297-302.
  • 6. Kocyigit BF, Berk E. Comparison of lumbosacral alignment in geriatric and non-geriatric patients suffering low back pain. Pak J Med Sci 2018;34:282-7.
  • 7. Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low-back pain matched for age, sex, and size. A prospective controlled clinical study. Spine 1994;19:1611-8.
  • 8. Harrison DD, Cailliet R, Janik TJ, et al. Elliptical modeling of the sagittal lumbar lordosis and segmental rotation angles as a method to discriminate between normal and low back pain subjects. J Spinal Disord 1998;11:430-9.
  • 9. Chun SW, Lim CY, Kim K, et al. The relationships between low back pain and lumbar lordosis: a systematic review and meta-analysis. Spine J 2017;17:1180-91.
  • 10. Van Der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984;27:361-8.
  • 11. Onyemaechi NO, Anyanwu GE, Obikili EN, et al. Impact of overweight and obesity on the musculoskeletal system using lumbosacral angles. Patient Prefer Adherence 2016;10:291-6.
  • 12. De Carvalho DE, Callaghan JP. Influence of automobile seat lumbar support prominence on spine and pelvic postures: a radiological investigation. Appl Ergon 2012;43:876-82.
  • 13. Lee JS, Goh TS, Park SH, et al. Radiographic measurement reliability of lumbar lordosis in ankylosing spondylitis. Eur Spine J 2013;22:813-8.
  • 14. Lee JS, Suh KT, Kim JI, et al. Analysis of sagittal balance of ankylosing spondylitis using spinopelvic parameters. J Spinal Disord Tech 2014;27:E94-8.
  • 15. Shin JK, Lee JS, Goh TS, et al. Correlation between clinical outcome and spinopelvic parameters in ankylosing spondylitis. Eur Spine J 2014;23:242-7.
  • 16. Evcik D, Yucel A. Lumbar lordosis in acute and chronic low back pain patients. Rheumatol Int 2003;23:163-5.
  • 17. Tsuji T, Matsuyama Y, Sato K, et al. Epidemiology of low back pain in the elderly: correlation with lumbar lordosis. J Orthop Sci 2001;6:307-11.
  • 18. Pan T, Qian BP, Qiu Y. Comparison of sagittal spinopelvic alignment in patients with ankylosing spondylitis and thoracolumbar fracture. Medicine (Baltimore) 2016;95:e2585.
  • 19. Sieper J, van der Heijde D. Review: nonradiographic axial spondyloarthritis: new definition of an old disease? Arthritis Rheum 2013;65:543-51.
  • 20. Park JW, Kim MJ, Lee JS, et al. Impact of tumour necrosis factor inhibitor versus non-steroidal anti-inflammatory drug treatment on radiographic progression in early ankylosing spondylitis: Its relationship to inflammation control during treatment. Arthritis Rheumatol 2018;8.
  • 21. Maksymowych WP, Morency N, Conner-Spady B, et al. Suppression of inflammation and effects on new bone formation in ankylosing spondylitis: evidence for a window of opportunity in disease modification. Ann Rheum Dis 2013;72:23-8.
  • 22. Deminger A, Klingberg E, Geijer M, et al. A five-year prospective study of spinal radiographic progression and its predictors in men and women with ankylosing spondylitis. Arthritis Res Ther 2018;20:162.
  • 23. Vaz G, Roussouly P, Berthonnaud E, et al. Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J 2002;11:80-7.
  • 24. Gottfried ON, Daubs MD, Patel AA, et al. Spinopelvic parameters in postfusion flatback deformity patients. Spine J 2009;9:639-47.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
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