Different Phenotypes of Osteoarthritis in the Lumbar Spine Reflected by Demographic and Clinical Characteristics: The Johnston County Osteoarthritis Project

Abstract

ObjectiveTo determine if associations between demographic and clinical characteristics and appendicular joint osteoarthritis (OA) reflect different phenotypes of OA in the lumbar spine.MethodsParticipants were from the Johnston County OA Project. Demographic information consisted of age, sex, and race (white and African American), and clinical characteristics consisted of body mass index (BMI), low back pain and injury, and knee, hip, and hand OA. Participants were categorized as having spine OA, facet joint OA, both spine OA and facet joint OA, or neither spine OA nor facet joint OA (referent group). Multinomial regression models were used to determine odds ratios (ORs) and 95% confidence intervals (95% CIs).ResultsOf 1,793 participants, the mean ± SD age was 66.2 ± 10.1 years, and the mean ± SD BMI was 30.7 ± 6.2. The majority of the participants were women (n = 1,144 [63.8%]), and 31.8% of the participants (n = 570) were African American. Eighteen percent of participants had neither spine OA nor facet joint OA, 22.8% had facet joint OA, 13.2% had spine OA, and 46.0% had both spine OA and facet joint OA. In adjusted analyses, African Americans were less likely to have facet joint OA (OR 0.68 [95% CI 0.49–0.95]) or both spine OA and facet joint OA (OR 0.51 [95% CI 0.37–0.70]). Women were more likely to have facet joint OA (OR 1.71 [95% CI 1.24–2.36]). Having a BMI of ≥30 was associated with having facet joint OA (OR 1.76 [95% CI 1.28–2.42]) and both spine OA and facet joint OA (OR 1.85 [95% CI 1.37–2.51]). Knee OA was associated with all 3 OA groups, while lower back injury was associated only with those with spine OA. Participants with hip OA were less likely to have facet joint OA.ConclusionRace, sex, BMI, hip OA, and lower back injury may help identify different OA phenotypes in the lumbar spine.

Biomarker clusters differentiate phenotypes of lumbar spine degeneration and low back pain: The Johnston County Osteoarthritis Project

“…Both DSN and OST were dichotomized as absent (none) or present (mild, moderate, or severe). Our prior analyses have examined different cut-offs for defining DSN and OST without any significant change in the findings [ 5 , 6 , 9 – 11 ]. The intra-rater reliability of this radiologist for the spine features has been reported previously with weighted kappa scores of 0.89 for DSN, 0.90 for OST, and 0.73 for FOA [ 10 ].…”

Predictors of Lumbar Spine Degeneration and Low Back Pain in the Community: The Johnston County Osteoarthritis Project

“…FOA was graded as absent or present at each lumbar level, while DSN and OST were graded in a semiquantitative fashion (0 = none, 1 = mild, 2 = moderate, and 3 = severe). Spine OA was defined as the presence of at least mild OST and mild DSN at the same vertebral level (23,24), which is similar to studies that define spine degeneration with the Kellgren/Lawrence (K/L) atlas (13,17). Spondylolisthesis was graded based on the translation of the vertebrae relative to the diameter of the affected intervertebral disc space, with 0 = no listhesis, 1 = ≤25%, 2 = 26-50%, 3 = 51-75%, 4 = 76-100%, and 5 = >100% translation.…”

Prevalence of multimorbid degenerative lumbar spinal stenosis with knee and/or hip osteoarthritis: protocol for a systematic review and meta-analysis

“…However, there is evidence suggesting knee OA and low back pain commonly co-exist [ 24 ] and low back pain has been identified as a risk factor for the development of knee pain in older adults [ 35 ]. A recent study also found the presence of radiographic knee OA was associated with all phenotypes of spinal OA (odds ratios ranging from 1.8 to 4.3) [ 36 ], which may represent the spinal changes found in LSS.…”