Ab0514 preliminary Data on the Study of the Possibility of Using Ultrasound to Objectify the Mobility of the Spine in Ankylosing Spondylitis

Abstract

Background:Spinal damage with limited mobility requires the search for diagnostic methods that allow us to accurately and quantitatively assess the developing decline in function and track this change in dynamics. One of these possible methods is ultrasound examination of the spine, which was recently described in the article Yurdakul O. V. [1].Objectives:to study the possibility of using ultrasound for dynamic monitoring of sagittal mobility of the spine in ankylosing spondylitis (AS).Methods:Ultrasound of the spine was performed in 15 patients with AS according to the method described in the article Yurdakul O. V. - determination of the sonographic distance between the spinous processes C5-C6, Th11-Th12 and L4-L5 of the vertebra (initial - vertical position, and when tilted - maximum sagittal flexion). All patients underwent a double examination: at inclusion in the study and after 2 weeks. The average age of the patients was 40.8±11.4 years, and the average duration of the disease was 5.5±3.5 years. 93.3% of patients were positive for HLA-B27. All patients were treated with nonsteroidal anti-inflammatory drugs, and 9 (60%) had biological therapy. The differences (Δ) between the indicators obtained on the first day and after 2 weeks - were calculated and further compared.Results:During 2 weeks of follow-up, ESR practically did not change (it was 16 [6;48], after 2 weeks 14 [6;27], p=0.45), CRP decreased by 3.5 times (22.3 [2.5;40.5] and 5.9 [3.0;23.7], p=0.4), BASDAI (7.2-3.1,p=0.003), ASDAS-CRP (3.7-2.2,p=0.001) and BASFI (5.5-2.5, p=0.001), but not BASMI 10 (24-22, p=0.18). There were also no significant changes in mobility indicators according to sonographic measurements for 2 weeks. However, the correlation analysis of the dynamics of indicators for the study period showed the following results (see the Table 1):Table 1.Correlation (r) between spinal ultrasound parameters and AS activity indices and metrological indices at the beginning of the study and after 2 weeks.Δ of the indicatorsΔiС5-С6ΔsС5-С6ΔiTh11-Th12ΔsTh11-Th12ΔiL4-L5ΔsL4-L5ΔESR-0.5*-0.4*-0.3-0.2-0.5*-0.4*ΔCRP-0.3-0.1-0.4-0.5-0.4*-0.7*ΔASDAS-0/4-0.50.1-0.30.10.2ΔBASDAI-0.2-0.1-0.2-0.3-0.3*-0.5*ΔBASFI-0.6*-0.5*-0.50.20.3-0.3ΔBASMI 10-0.2-0.1-0.2-0.3-0.3*-0.5*Note: *-p<0.05, Δi - C5-6, Th11-12, L4-5, mm – the difference between the indicators obtained by ultrasound in the vertical position at admission and after 2 weeks, Δs – the difference between the indicators at maximum sagittal flexion.A correlation was found between an increase in the interspinous distance in the cervical and lumbar spine and a decrease in the level of ESR, and in the lumbar spine - with CRP. There is also a significant relationship between the activity of AS according to the BASDAI index and the mobility of the spine at the level of L4-5, which was manifested by an increase in the interspinous distance with a decrease in the activity of the disease. Sonographic measurements of all three levels of the spine show a negative correlation with the combined metrological index BASMI 10, most significantly with the L4-5 level of the spine.Conclusion:The method of ultrasound examination of spinal mobility in AS allows not only to objectify the indicators, but can also be used to monitor the function of the axial skeleton during follow-up.References:[1]Yurdakul APA, e.a. Medicine: September 2018; doi: 10.1097/MD.0000000000012609.Disclosure of Interests:None declared.