Rheumatology (Oxford, England) · 2025
Ankylosed posterior spinal structures: the catalyst for syndesmophytes growth and impaired spinal mobility in axial spondyloarthritis.
СтатьяНазвание и аннотация: Перевод в очереди
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Liao Simin, Zhu Jian, Cheng Liuquan, Zhao Zheng, Luo Gui, Song Chuan, Zhang Jiaxin, Huang Feng
Аннотация
OBJECTIVE: To identify risk factors for spinal structural progression and determine the most significant impact on syndesmophytes growth and impaired spinal mobility in axSpA.
METHODS: Baseline and 2-year follow-up clinical, thoracic and lumbar spine CT data of 94 patients were analysed. A vertebral syndesmophytes unit (VSU) was defined as syndesmophytes anterior to the vertebral body and its intervertebral disc space, with volumes calculated by Mimics software. Bilateral facet/costovertebral/costotransverse joints were assessed. Syndesmophytes growth was assessed with a linear mixed-effects model, and posterior spinal structures progression were evaluated with generalized linear mixed-effects models. Influence of spinal changes on BASMI-change was analysed with a generalized linear model. Conditional R2 values quantified model fit, with coefficient percentage representing each variable's contribution.
RESULTS: Syndesmophytes growth occurred in 44.99% of VSUs. Baseline facet joints ankylosis/erosion and costovertebral/costotransverse joints ankylosis were associated with syndesmophytes growth (P < 0.05). Contributing factors included changes of facet joints (56.84%), costotransverse joints (17.65%), costovertebral joints (16.26%) and age (6.08%). Structural progression was found in 8.79% (281/3196) of facet joints, among which 43.77% progressed to ankylosis, with age (6.56%) and baseline ankylosis/erosion (48.02%) driving this change. In addition, 16.31% of costovertebral joints progressed, with age (3.63%) and 2-year costotransverse lesions progression (12.30%) as significant predictors. And 2.07% of costotransverse joints progressed, with costovertebral lesions (25.61%) and age (0.81%) correlating significantly. Ankylosed costovertebral joints (25.10%), facet joints (16.86%), costotransverse joints (12.72%) and syndesmophytes growth (4.45%) significantly contribute to BASMI-change.
CONCLUSIONS: Ankylosed posterior spinal structures emerged as the paramount driver of syndesmophytes growth and a critical impediment to spinal mobility in axSpA.
METHODS: Baseline and 2-year follow-up clinical, thoracic and lumbar spine CT data of 94 patients were analysed. A vertebral syndesmophytes unit (VSU) was defined as syndesmophytes anterior to the vertebral body and its intervertebral disc space, with volumes calculated by Mimics software. Bilateral facet/costovertebral/costotransverse joints were assessed. Syndesmophytes growth was assessed with a linear mixed-effects model, and posterior spinal structures progression were evaluated with generalized linear mixed-effects models. Influence of spinal changes on BASMI-change was analysed with a generalized linear model. Conditional R2 values quantified model fit, with coefficient percentage representing each variable's contribution.
RESULTS: Syndesmophytes growth occurred in 44.99% of VSUs. Baseline facet joints ankylosis/erosion and costovertebral/costotransverse joints ankylosis were associated with syndesmophytes growth (P < 0.05). Contributing factors included changes of facet joints (56.84%), costotransverse joints (17.65%), costovertebral joints (16.26%) and age (6.08%). Structural progression was found in 8.79% (281/3196) of facet joints, among which 43.77% progressed to ankylosis, with age (6.56%) and baseline ankylosis/erosion (48.02%) driving this change. In addition, 16.31% of costovertebral joints progressed, with age (3.63%) and 2-year costotransverse lesions progression (12.30%) as significant predictors. And 2.07% of costotransverse joints progressed, with costovertebral lesions (25.61%) and age (0.81%) correlating significantly. Ankylosed costovertebral joints (25.10%), facet joints (16.86%), costotransverse joints (12.72%) and syndesmophytes growth (4.45%) significantly contribute to BASMI-change.
CONCLUSIONS: Ankylosed posterior spinal structures emerged as the paramount driver of syndesmophytes growth and a critical impediment to spinal mobility in axSpA.