Lumbar Spine Abnormalities in Patients With Obstructive Sleep Apnoea

Abstract

Previous studies suggested cervical spondylosis as a risk factor for development of obstructive sleep apnoea (OSA). We aimed to assess lumbar disc degeneration in patients with OSA and correlate the findings with symptoms and disease severity. Twenty-seven patients with OSA and 29 non-OSA controls underwent sleep studies and lumbar magnetic resonance imaging (MRI), and completed the Epworth Sleepiness Scale and the 24-item Roland‐Morris Disability Questionnaire questionnaires. Plasma klotho was determined with enzyme-linked immunosorbent assay.Patients with OSA had higher number of disc bulges (4.6±3.7 vs. 1.7±2.5, p<0.01) and anterior spondylophytes (2.7±4.2 vs. 0.8±2.1, p<0.01), increased Pfirrmann score (16.7±4.7 vs. 13.2±4.1, p<0.01) and vertebral fatty degeneration (7.8±4.7 vs. 3.8±3.7, p<0.01). Markers of OSA severity, including the apnoea-hypopnoea index, oxygen desaturation index and percentage of total sleep time spent with saturation <90% as well as plasma levels of klotho were correlated with the number of disc bulges and anterior spondylophytes following adjustment on age, gender and body mass index (all p<0.05). Markers of disc degeneration were related to chronic pain.OSA is associated with lumbar spondylosis likely through chronic intermittent hypoxaemia inducing inflammation in the lumbar discs. Our study highlights the importance of lumbar imaging in patients with OSA reporting lower back pain.

A case report of two obstructive sleep apnea patients with cervical spine abnormalities and relevant literature review

“…Cervical spondylosis was reported as a rare risk factor for OSA. 1 Sonnesen et al 2 recruited 57 OSA patients in Denmark, 21.1% of whom were found to have coexistent…”

“…The progression of OSA was associated with a history of cervical fusions and osteophytes. Cervical spondylosis was reported as a rare risk factor for OSA 1 . Sonnesen et al 2 recruited 57 OSA patients in Denmark, 21.1% of whom were found to have coexistent cervical spine fusion abnormalities.…”

“…internal fixation 7 years ago. Upper airway computed tomography (UACT) showed results as follows: (1) Posterior displacement of the soft palate, resulting in narrowing of the sagittal diameters of the oropharyngeal cavity. (2) Postoperative changes in the cervical spine (Figure 1).…”