Cheung Samuel Tin Yan, Tsang Helen Hoi Lun, Cheung Prudence Wing Hang, Cheung Jason Pui Yin
Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.
Rheumatol Adv Pract. 2024 Feb 6;8(1):rkae015. doi: 10.1093/rap/rkae015. eCollection 2024.
Using whole spine sagittal T2 MRI, we aimed to compare the severity and prevalence of disc degeneration (DD) in axial SpA patients the general population and to determine any association between spinal inflammation, structural changes, mobility and DD among SpA patients.
Two prospectively collected cohorts of SpA patients ( = 411) and the general population ( = 2007) were recruited. Eventually, 967 participants from the populational cohort and 304 participants from the SpA cohort were analysed. Two hundred and nineteen matched pairs were generated by propensity score matching. Imaging parameters, including Pfirrmann grading, disc herniation, high-intensity zone, Schmorl's node, Modic change and anterior marrow change were studied and compared from C2/3 to L5/S1. DD was defined as Pfirrmann grade 4 or 5. Demographic factors, including age, sex and BMI, were collected. Multivariable linear regression was used to determine the association between spinal inflammation [Spondyloarthritis Research Consortium of Canada (SPARCC) spine MRI index], structural changes [modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS)] and mobility (BASMI) with lumbar Pfirrmann score.
SpA patients had lower prevalence of DD ( < 0.001). The disease stage-stratified regression model showed that SPARCC spinal MRI index was associated with higher lumbar Pfirrmann scores in early disease (β = 0.196, = 0.044), whereas mSASSS was associated with lower lumbar Pfirrmann scores in later disease (β = -0.138, = 0.038). Males had higher mSASSS ( < 0.001) and lower odds of whole spine DD (odds ratio = 0.622, = 0.028).
SpA patients had lower DD severity than the general population. Males had higher mSASSSs, and increased mSASSS at later disease was associated with less severe DD.
通过全脊柱矢状面T2加权磁共振成像（MRI），我们旨在比较轴向脊柱关节炎（SpA）患者与普通人群椎间盘退变（DD）的严重程度和患病率，并确定SpA患者脊柱炎症、结构改变、活动度与DD之间的任何关联。
招募了两个前瞻性收集的队列，分别为SpA患者队列（n = 411）和普通人群队列（n = 2007）。最终，分析了来自普通人群队列的967名参与者和来自SpA队列的304名参与者。通过倾向得分匹配生成了219对匹配对。研究并比较了从C2/3至L5/S1的成像参数，包括Pfirrmann分级、椎间盘突出、高强度区、Schmorl结节、Modic改变和椎体前缘骨髓改变。DD定义为Pfirrmann 4级或5级。收集了人口统计学因素，包括年龄、性别和体重指数（BMI）。使用多变量线性回归确定脊柱炎症[加拿大脊柱关节炎研究联盟（SPARCC）脊柱MRI指数]、结构改变[改良斯托克强直性脊柱炎脊柱评分（mSASSS）]和活动度（BASMI）与腰椎Pfirrmann评分之间的关联。
SpA患者的DD患病率较低（P < 0.001）。疾病分期分层回归模型显示，在疾病早期，SPARCC脊柱MRI指数与较高的腰椎Pfirrmann评分相关（β = 0.196，P = 0.044），而在疾病后期，mSASSS与较低的腰椎Pfirrmann评分相关（β = -0.138，P = 0.038）。男性的mSASSS较高（P < 0.001），全脊柱DD的几率较低（比值比 = 0.622，P = 0.028）。
SpA患者的DD严重程度低于普通人群。男性的mSASSS较高，且疾病后期mSASSS增加与DD严重程度减轻相关。
