Direction of the formation of anterior lumbar vertebral osteophytes

Kasai, Yuichi; Kawakita, Eiji; Sakakibara, Toshihiko; Akeda, Koji; Uchida, Atsushi

doi:10.1186/1471-2474-10-4

Cited by 31 publications

(29 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The lower part of the thoracic spine and the upper part of the lumbar spine are the most frequently involved regions in both conditions (6)(7)(8). Osteophytes, commonly referred to as bone spurs, are bony projections that form along joint margins (9).…”

mentioning

confidence: 99%

A comparison of new bone formation in patients with ankylosing spondylitis and patients with diffuse idiopathic skeletal hyperostosis: A retrospective cohort study over six years

Baraliakos

Listing

Buschmann

et al. 2012

Arthritis & Rheumatism

View full text Add to dashboard Cite

Objective. Ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) are both characterized by new bone formation in the spine but presumably have a different pathogenesis. This study was undertaken to compare the natural course of new bone formation in AS and DISH.Methods. Lateral radiographs of the cervical and lumbar spine from AS and DISH patients obtained at >2 time points within 6 years were analyzed to quantify osteophyte development. Radiographs were scored in a blinded manner by 2 readers using the modified Stoke AS Spine Score (mSASSS). Bone spurs were categorized as having an angle of <45°or >45°.Results. AS patients (n ‫؍‬ 146) were younger than DISH patients (n ‫؍‬ 141) (mean ؎ SD 54.2 ؎ 12.3 years versus 60.3 ؎ 7.7 years). Symptom duration (mean ؎ SD) was 23.6 ؎ 11.2 years in AS patients and 21.6 ؎ 12.4 years in DISH patients. The mSASSS at baseline was lower in DISH patients (mean ؎ SD 14.3 ؎ 6.7) than in AS patients (20.5 ؎ 14.5) but had increased by a similar amount at followup (3.3 ؎ 4.2 versus 4.1 ؎ 9.5). The mean mSASSS progression rate per year (1.3 units) was also comparable. The mean ؎ SD number of syndesmophytes per patient was higher in AS (5.7 ؎ 5.5) than DISH (2.7 ؎ 2.8) patients (P < 0.001), while degenerative bone spurs (mean ؎ SD) were more frequent in DISH (1.4 ؎ 1.8) than AS (1.0 ؎ 1.4) patients. AS patients developed more new bone spurs with an angle of <45°than >45°per patient (mean ؎ SD 2.1 ؎ 2.7 versus 0.6 ؎ 0.9) (P < 0.001), while similar amounts of both types of bone formation were seen in DISH patients. Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) are the 2 most common diseases that are characterized by ossification of the ligaments and tendons in both the axial skeleton and peripheral sites (1-3). Formation of new bone in the spine is most typically seen at the anterior site of the vertebrae, but it does also occur at other sites in both diseases (4,5). The lower part of the thoracic spine and the upper part of the lumbar spine are the most frequently involved regions in both conditions (6-8). Osteophytes, commonly referred to as bone spurs, are bony projections that form along joint margins (9). Conclusion. Our findings indicate that the rates of new bone formation in AS andThe radiographic appearance of both diseases is very similar, but the underlying pathology differs. Although there is no doubt that both spinal inflammation and new bone formation occur in AS, exactly how they are related is not so clear (10). Even less is known about DISH in this regard. While immune-mediated inflammatory rheumatic processes largely based on a genetic background are believed to occur in AS (11), DISH is

show abstract

mentioning

confidence: 99%

A comparison of new bone formation in patients with ankylosing spondylitis and patients with diffuse idiopathic skeletal hyperostosis: A retrospective cohort study over six years

Baraliakos

Listing

Buschmann

et al. 2012

Arthritis & Rheumatism

View full text Add to dashboard Cite

show abstract

“…One study has suggested that bone spurs with an angle of <45° to the anterior vertebral cortex be defined as syndesmophytes, while those with an angle of >45° are defined as degenerative (). However, vertical bone spurs have also been reported in patients with degenerative disorders (). The group considered the 45° angle cutoff as insufficiently supported by the evidence and the consensus was to score bone spurs as syndesmophytes irrespective of the angle unless the bone spur was considered horizontal at the location of a degenerating disc.…”

Section: Resultsmentioning

confidence: 99%

“…Since the original validation of the mSASSS and the pivotal comparative analysis (), there have been further data published on radiographic findings in patients with SpA, healthy individuals, and those with nonspecific spinal disorders (). However, there have been no further studies aimed at standardization and clarification of methodology aimed at enhancing reliability and in assessing the additional value of the anteroposterior (AP) view.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of the Spondyloarthritis Radiography Module for Calibration of Readers Using the Modified Stoke Ankylosing Spondylitis Spine Score

Maksymowych

Learch

Lambert

et al. 2013

Arthritis Care & Research

View full text Add to dashboard Cite

Objective. To develop and validate a reference image module aimed at calibration of readers using the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) to assess radiographic progression in spondyloarthritis. Methods. Our working group comprised 6 rheumatologists and 3 musculoskeletal radiologists. The following developmental steps were conducted: 1) review of the literature to identify aspects of the mSASSS requiring methodologic clarity; 2) independent assessment of baseline and 2-year radiographs from 25 patients using the mSASSS (pilot exercise); 3) development of a training module (the Spondyloarthritis Radiography [SPAR] module) that clarifies definitions, rules, and scoring methodology and a set of reference radiographic images; 4) scoring exercise 1 by 6 readers on 39 patients, where baseline and 2-year radiographs were scored blinded to time point; and 5) revision of the SPAR module followed by scoring exercise 2 conducted by the same 6 readers on 35 patients. Reliability of status and 2-year change scores was assessed by the intraclass correlation coefficient (ICC) method.

show abstract

“…Claw osteophytes are more common at T12 to L2, whilst traction osteophytes (pointing away from the disc) are more common at L3 to L5. Osteophytes were found in 91% of people in an autopsy study …”

Section: Did You Know?mentioning

confidence: 98%

“…The inverse relationship between osteophytes and osteoporosis is well recognised . One study of the spinal X‐rays of postmenopausal women found an inverse relationship between vertebral (osteoporotic) fractures and osteophytes with an odds ratio of 0.38.…”

Section: Did You Know?mentioning

confidence: 99%