nach oben

Clinical Rheumatology

Erschienen in:

02.01.2020 | Original Article

Low pelvic incidence is associated with Andersson lesions in ankylosing spondylitis patients with kyphosis

verfasst von: Di-yu Song, Guo-quan Zheng, Tian-hao Wang, Deng-bin Qi, Yan Wang

Erschienen in: Clinical Rheumatology | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Abstract

Introduction/objectives

This study was to investigate the role of pelvic incidence (PI) in the development of Andersson lesions (ALs) in ankylosing spondylitis (AS) patients with kyphosis and to evaluate the difference in sagittal spinopelvic parameters between inflammatory ALs and mechanical ALs.

Method

A total of 135 AS patients with kyphosis were reviewed. The patients were classified into AL group and non-AL group based on the presence or absence of ALs. Additionally, AS patients with ALs were also classified as either inflammatory or mechanical lesions depending on the radiological features of the lesions. The sagittal spinopelvic parameters of all these AS patients were measured and compared. Logistic regression analysis was performed to determine the powerful variables for predicting ALs in AS patients.

Results

ALs were detected in 34 patients (25.2%) of the total 135 AS patients. The mean PI of the AL group was 40.0°, which was significantly lower than that (48.3°) of the non-AL group (P < 0.001). No statistically significant difference was observed in PI (P = 0.350) between the inflammatory lesion group and the mechanical lesion group. Logistic regression analysis showed that only PI was a statistically significant risk factor for ALs (P < 0.001) and was negatively correlated with ALs (odds ratio = 0.76).

Conclusions

These data suggest that low PI is closely associated with ALs in AS patients with kyphosis and that it might be a possible risk factor for the development of ALs. Moreover, both inflammatory and mechanical ALs patients had similarly low PI.

Key Points

• Low PI was closely associated with ALs in AS patients with kyphosis and might be a possible risk factor for development of ALs.

• Either inflammatory or mechanical ALs patients had similar low PI.

Bron JL, de Vries MK, Snieders MN, van der Horst-Bruinsma IE, van Royen BJ (2009) Discovertebral (Andersson) lesions of the spine in ankylosing spondylitis revisited. Clin Rheumatol 28(8):883–892. https://doi.org/10.1007/s10067-009-1151-xCrossRefPubMedPubMedCentral

Park YS, Kim JH, Ryu JA, Kim TH (2011) The Andersson lesion in ankylosing spondylitis: distinguishing between the inflammatory and traumatic subtypes. J Bone Joint Surg Br Vol 93(7):961–966. https://doi.org/10.1302/0301-620X.93B7.26337CrossRef

Shaik I, Bhojraj SY, Prasad G, Nagad PB, Patel PM, Kashikar AD, Kumar N (2018) Management of Andersson lesion in ankylosing spondylitis using the posterior-only approach: a case series of 18 patients. Asian Spine J 12(6):1017–1027. https://doi.org/10.31616/asj.2018.12.6.1017CrossRefPubMedPubMedCentral

Kim KT, Lee SH, Suk KS, Lee JH, Im YJ (2007) Spinal pseudarthrosis in advanced ankylosing spondylitis with sagittal plane deformity: clinical characteristics and outcome analysis. Spine 32(15):1641–1647. https://doi.org/10.1097/BRS.0b013e318074c3ceCrossRefPubMed

Jobanputra P, Kirkham B, Duke O, Crockard A, Panayi GS (1988) Discovertebral destruction in ankylosing spondylitis complicated by spinal cord compression. Ann Rheum Dis 47(4):344–347CrossRef

Qiao M, Qian BP, Qiu Y, Mao SH, Wang YH (2019) Radiologic and pathological investigation of Pseudarthrosis in ankylosing spondylitis: distinguishing between inflammatory and traumatic etiology. J Rheumatol 46(3):259–265. https://doi.org/10.3899/jrheum.171249CrossRefPubMed

Boulay C, Tardieu C, Hecquet J, Benaim C, Mouilleseaux B, Marty C, Prat-Pradal D, Legaye J, Duval-Beaupere G, Pelissier J (2006) Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J 15(4):415–422. https://doi.org/10.1007/s00586-005-0984-5CrossRefPubMed

Carender CN, Morris WZ, Poe-Kochert C, Thompson GH, Son-Hing JP, Liu RW (2016) Low pelvic incidence is associated with proximal junctional kyphosis in patients treated with growing rods. Spine 41(9):792–797. https://doi.org/10.1097/BRS.0000000000001352CrossRefPubMed

Weinberg DS, Morris WZ, Gebhart JJ, Liu RW (2016) Pelvic incidence: an anatomic investigation of 880 cadaveric specimens. Eur Spine J 25(11):3589–3595. https://doi.org/10.1007/s00586-015-4317-zCrossRefPubMed

10.

Legaye J, Duval-Beaupere G, Hecquet J, Marty C (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7(2):99–103CrossRef

11.

Hanson DS, Bridwell KH, Rhee JM, Lenke LG (2002) Correlation of pelvic incidence with low- and high-grade isthmic spondylolisthesis. Spine 27(18):2026–2029CrossRef

12.

Toy JO, Tinley JC, Eubanks JD, Qureshi SA, Ahn NU (2012) Correlation of sacropelvic geometry with disc degeneration in spondylolytic cadaver specimens. Spine 37(1):E10–E15. https://doi.org/10.1097/BRS.0b013e3182257bb0CrossRefPubMed

13.

Bae JS, Jang JS, Lee SH, Kim JU (2012) Radiological analysis of lumbar degenerative kyphosis in relation to pelvic incidence. Spine J 12(11):1045–1051. https://doi.org/10.1016/j.spinee.2012.10.011CrossRefPubMed

14.

Lee JS, Suh KT, Kim JI, Goh TS (2014) Analysis of sagittal balance of ankylosing spondylitis using spinopelvic parameters. J Spinal Disord Tech 27(3):E94–E98. https://doi.org/10.1097/BSD.0b013e31829186c1CrossRefPubMed

15.

Debarge R, Demey G, Roussouly P (2010) Radiological analysis of ankylosing spondylitis patients with severe kyphosis before and after pedicle subtraction osteotomy. Eur Spine J 19(1):65–70. https://doi.org/10.1007/s00586-009-1158-7CrossRefPubMed

16.

Shin JK, Lee JS, Goh TS, Son SM (2014) Correlation between clinical outcome and spinopelvic parameters in ankylosing spondylitis. Eur Spine J 23(1):242–247. https://doi.org/10.1007/s00586-013-2929-8CrossRefPubMed

17.

Wang T, Zhao Y, Zheng G, Wang Y, Wang C, Wang Z, Wang Y (2018) Can pelvic tilt be restored by spinal osteotomy in ankylosing spondylitis patients with thoracolumbar kyphosis? A minimum follow-up of 2 years. J Orthop Surg Res 13(1):172. https://doi.org/10.1186/s13018-018-0874-2CrossRefPubMedPubMedCentral

18.

van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 27(4):361–368CrossRef

19.

Qian BP, Jiang J, Qiu Y, Wang B, Yu Y, Zhu ZZ (2014) The presence of a negative sacral slope in patients with ankylosing spondylitis with severe thoracolumbar kyphosis. J Bone Joint Surg Am 96(22):e188. https://doi.org/10.2106/JBJS.M.01070CrossRefPubMed

20.

Protopsaltis T, Schwab F, Bronsard N, Smith JS, Klineberg E, Mundis G, Ryan DJ, Hostin R, Hart R, Burton D, Ames C, Shaffrey C, Bess S, Errico T, Lafage V, International Spine Study G (2014) TheT1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life. J Bone Joint Surg Am 96(19):1631–1640. https://doi.org/10.2106/JBJS.M.01459CrossRefPubMed

21.

Barman A, Sinha MK, Rao PB (2016) Discovertebral (Andersson) lesion of the ankylosing spondylitis, a cause of autonomic dysreflexia in spinal cord injury. Spinal Cord Ser Cases 2:16008. https://doi.org/10.1038/scsandc.2016.8CrossRefPubMedPubMedCentral

22.

Dave BR, Ram H, Krishnan A (2011) Andersson lesion: are we misdiagnosing it? A retrospective study of clinico-radiological features and outcome of short segment fixation. Eur Spine J 20(9):1503–1509. https://doi.org/10.1007/s00586-011-1836-0CrossRefPubMedPubMedCentral

23.

Nikolaisen C, Nossent H (2005) Early histology in ankylosing spondylitis related spondylodiscitis supports its inflammatory origin. Scand J Rheumatol 34(5):396–398. https://doi.org/10.1080/03009740510026625CrossRefPubMed

24.

Fang D, Leong JC, Ho EK, Chan FL, Chow SP (1988) Spinal pseudarthrosis in ankylosing spondylitis. Clinicopathological correlation and the results of anterior spinal fusion. J Bone Joint Surg Br Vol 70(3):443–447CrossRef

25.

Roussouly P, Pinheiro-Franco JL (2011) Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J 20(Suppl 5):609–618. https://doi.org/10.1007/s00586-011-1928-xCrossRefPubMedPubMedCentral

26.

Gebhart JJ, Weinberg DS, Bohl MS, Liu RW (2016) Relationship between pelvic incidence and osteoarthritis of the hip. Bone Joint Res 5(2):66–72. https://doi.org/10.1302/2046-3758.52.2000552CrossRefPubMedPubMedCentral

27.

Gebhart JJ, Bohl MS, Weinberg DS, Cooperman DR, Liu RW (2015) Pelvic incidence and acetabular version in slipped capital femoral epiphysis. J Pediatr Orthop 35(6):565–570. https://doi.org/10.1097/BPO.0000000000000342CrossRefPubMed

28.

Cho KJ, Suk SI, Park SR, Kim JH, Kang SB, Kim HS, Oh SJ (2010) Risk factors of sagittal decompensation after long posterior instrumentation and fusion for degenerative lumbar scoliosis. Spine 35(17):1595–1601. https://doi.org/10.1097/BRS.0b013e3181bdad89CrossRefPubMed

29.

Le Huec JC, Aunoble S, Philippe L, Nicolas P (2011) Pelvic parameters: origin and significance. Eur Spine J 20(Suppl 5):564–571. https://doi.org/10.1007/s00586-011-1940-1CrossRefPubMedPubMedCentral

30.

Labelle H, Roussouly P, Berthonnaud E, Transfeldt E, O'Brien M, Chopin D, Hresko T, Dimnet J (2004) Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine 29(18):2049–2054CrossRef

Titel: Low pelvic incidence is associated with Andersson lesions in ankylosing spondylitis patients with kyphosis
verfasst von: Di-yu Song
Guo-quan Zheng
Tian-hao Wang
Deng-bin Qi
Yan Wang
Publikationsdatum: 02.01.2020
Verlag: Springer International Publishing
Erschienen in: Clinical Rheumatology / Ausgabe 5/2020
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04907-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Introduction/objectives

Method

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2020

A retrospective study on the predictive implications of clinical characteristics and therapeutic management in patients with rheumatoid arthritis-associated interstitial lung disease

Safety and efficacy of tocilizumab as monotherapy or in combination with methotrexate in Tunisian patients with active rheumatoid arthritis and inadequate response to disease-modifying anti-rheumatic drugs in conditions close to clinical practice

DFS pattern and DFS70 autoantibody testing: comments on the article “Investigation of anti-DFS70 antibody in patients with systemic autoimmune rheumatic diseases”

Ultrasonography supplements clinical exam to improve early rheumatoid arthritis disease activity monitoring in metatarsophalangeal joints

Diagnostic value of ultrasound versus dual-energy computed tomography in patients with different stages of acute gouty arthritis