Background: Although a substantial percentage of patients with rheumatoid arthritis (RA) experience low back pain, the characteristics of lumbar spine pathology in RA patients has been poorly investigated. In our institutions, lumbar spine radiographs indicated scoliosis in 26 patients. The present study aimed to clarify the characteristics of lumbar scoliosis in RA patients.
Methods: This is a retrospective study of 26 RA patients with lumbar scoliosis. Patient characteristics such as disease duration, disease stage and class according to Steinbrocker's classification, and medication for RA and osteoporosis were reviewed. Radiologic evaluation of scoliosis was performed at two different time points by measuring Cobb angles. The progression of scoliosis per year was calculated by dividing the change in Cobb angles by the number of years. Apical vertebral rotation, lateral listhesis, and the level of the intercrestal line at the first observation were also measured. The correlation between different factors and changes in the Cobb angles per year was analyzed.
Results: Majority of the patients had a long disease duration and were classified as stage 3 or 4 according to Steinbrocker's classification. During the observation period, most patients were treated with glucocorticoids. Unlike the previous studies on degenerative scoliosis, apical vertebral rotation, lateral listhesis, and the level of the intercrestal line at initial observation were not significantly related to the progression of scoliosis. Initial Cobb angles were inversely related to the progression of scoliosis. Patients who were treated with bisphosphonates showed slower progression of scoliosis.
Conclusions: Our results indicate that the characteristics of lumbar scoliosis in RA patients differ from those of degenerative lumbar scoliosis. Bone fragility due to the long disease duration, poor control of disease activity, and osteoporosis is possibly related to its progression.
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http://dx.doi.org/10.1186/1749-799X-9-30 | DOI Listing |
J Neurosurg Spine
January 2025
15Department of Neurological Surgery, University of California, San Francisco, California.
Objective: The goal of this study was to compare the impact of using a lower thoracic (LT) versus upper lumbar (UL) level as the upper instrumented vertebra (UIV) on clinical and radiographic outcomes following minimally invasive surgery for adult spinal deformity.
Methods: A multicenter retrospective study design was used. Inclusion criteria were age ≥ 18 years, and one of the following: coronal Cobb angle > 20°, sagittal vertical axis > 50 mm, pelvic tilt > 20°, pelvic incidence-lumbar lordosis mismatch > 10°.
J Pediatr Orthop
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Background: Vertebral body tethering (VBT) is a nonfusion surgical treatment for scoliosis. Recent data have shown that intraoperative correction is critical for successful curve correction over time. This study aims to evaluate the relationship between preoperative, intraoperative, and postoperative correction.
View Article and Find Full Text PDFChiropr Man Therap
January 2025
Northwestern Health Sciences University, 2501 W 84th Street, Bloomington, MN, 55431, USA.
Background: Some chiropractors use spinal x-rays to inform care, but the relationship between radiographic findings and outcomes is unclear. This study examined the association between radiographic findings and 30% improvement in back-related disability in older adults after receiving 12 weeks of chiropractic spinal manipulation and home exercise instruction.
Methods: This IRB-approved secondary analysis used randomized trial data of community-dwelling adults age ≥ 65 with chronic spinal pain and disability.
Bioengineering (Basel)
December 2024
Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China.
Background: Orthotic treatment is a well-acknowledged conservative treatment for moderate adolescent idiopathic scoliosis (AIS). The efficacy of this treatment is significantly determined by the forces applied to the bodies of patients. However, there is uncertainty regarding the optimal force levels that should be applied to the patient's torso by spinal orthosis.
View Article and Find Full Text PDFAsian Spine J
December 2024
Department of Spine Surgery and Orthopaedics, Xiangya Hospital of Central South University, Changsha, China.
Study Design: A retrospective study.
Purpose: This study aimed to compare the clinical effectiveness of en-bloc direct vertebrae rotation (DVR) to non-DVR for the correction of Lenke 5C.
Overview Of Literature: The primary goal of posterior correction is to preserve the lumbar spine and achieve a well-balanced spine.
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