Abstract
Ankylosing spondylitis (AS) has characteristics of spinal bone bridge and fusion. Although BMD reduction in AS may be presumed to be due to spinal inflammation, this study was designed to confirm whether immobilization of the spine due to syndesmophytes is related to BMD reduction, as immobilization itself is a risk factor for BMD reduction. Among male patients diagnosed with AS according to the modified New York criteria, those who underwent bone density tests with quantitative computed tomography (QCT) were retrospectively analyzed through a chart review. The correlation between the presence or absence of bone bridges for each vertebral body level of the L spine confirmed with radiography and BMD confirmed with QCT was analyzed. A total of 47 male patients with AS were enrolled. The mean patient age was 46.8 ± 8.2 years, and the mean disease duration was 7.9 ± 6.4 years. The trabecular BMD of the lumbar spine (L1-L4) ranged from 23.1 to 158.45 mg/cm3 (mean 102.2 ± 37 mg/cm3), as measured with QCT. The lumbar BMD measurements showed that 30 patients (63.8%) had osteopenia or osteoporosis. Bone bridge formation showed a negative correlation with BMD. Low BMD was significantly correlated with bone bridge in the vertebral body (p < 0.05). Positive correlations were observed between bone bridge score and BASMI flexion score, whereas significant negative correlations were found between BMD and BASMI flexion score (p < 0.05). Decreased mobility of the vertebrae due to bone bridge formation affects the decrease in BMD in patients with AS.
Highlights
Introduction and objectiveAnkylosing spondylitis (AS) has characteristics of spinal bone bridge and fusion
bone mineral density (BMD) reduction in AS may be presumed to be due to spinal inflammation, this study was designed to confirm whether immobilization of the spine due to syndesmophytes is related to BMD reduction, as immobilization itself is a risk factor for BMD reduction
Bone bridge formation showed a negative correlation with BMD
Summary
Ankylosing spondylitis (AS) has characteristics of spinal bone bridge and fusion. BMD reduction in AS may be presumed to be due to spinal inflammation, this study was designed to confirm whether immobilization of the spine due to syndesmophytes is related to BMD reduction, as immobilization itself is a risk factor for BMD reduction. Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the sacroiliac joints and the axial spine, and it affects the peripheral joints. Syndesmophyte is produced through bone formation in the spine, and the process of bone loss increases the risk of osteoporosis and fractures [1]. In most cases of AS patients, the burden of disease is due to a combination of structural bone damage and inflammation [2]. Structural damage acts on patients by causing the loss of disability and permanent loss of function [3]
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