{"title":"Active Rheumatoid Arthritis and Scoliosis: A Mid-Term Cohort Study.","authors":"Shintaro Honda, Koichi Murata, Bungo Otsuki, Takayoshi Shimizu, Takashi Sono, Soichiro Masuda, Koichiro Shima, Masaki Sakamoto, Takayuki Fujii, Akira Onishi, Kosaku Murakami, Hideo Onizawa, Masao Tanaka, Akio Morinobu, Shuichi Matsuda","doi":"10.1097/BRS.0000000000005035","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To elucidate the factors related to the progression of scoliosis in patients with rheumatoid arthritis (RA) using longitudinal cohort data.</p><p><strong>Background: </strong>Of patients, 30% with RA have lumbar scoliosis. However, the effectiveness of current treatment methods in preventing the progression of scoliosis is not well understood due to a lack of longitudinal studies.</p><p><strong>Patients and methods: </strong>We enrolled 180 patients with RA who were followed up for over 2 years, all of whom underwent standing spinal x-rays. These patients were categorized based on their disease activity score-28 with erythrocyte sedimentation rate into 2 groups: (1) those in remission (n = 76) and (2) those in nonremission (n = 104). We evaluated various radiographic measures, including C7 center sacral vertical line, pelvic obliquity, major Cobb angle, and curve location.</p><p><strong>Results: </strong>Fifty-three (29.4%) patients presented progression of scoliosis during a mean follow-up period of 4.8 years. Patients in the nonremission showed larger Cobb angle at baseline and final follow-up, compared with those in remission. The annual progression rate of the curve was also greater in the nonremission group (1.04°/yr) than in the remission group (0.59°/yr, P = 0.001). There was no difference in the incidence of new vertebral fractures. The presence of a baseline Cobb angle of 10° or more [odds ratio (OR): 3.14; 95% CI: 1.38-7.13; P = 0.006], glucocorticoid use (OR: 2.88; 95% CI: 1.18-7.06; P = 0.021), and nonremission at baseline (OR: 2.83; 95% CI: 1.25-6.41; P = 0.012) were significant risk factors for progression of scoliosis.</p><p><strong>Conclusion: </strong>RA disease activity is linked to the progression of scoliosis in patients with RA. Patients with RA who present with initial scoliosis of ≥10°, require glucocorticoids for treatment and are in nonremission at baseline may be at high risk for scoliosis progression.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"252-258"},"PeriodicalIF":2.6000,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005035","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/15 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Study design: Retrospective cohort study.
Objective: To elucidate the factors related to the progression of scoliosis in patients with rheumatoid arthritis (RA) using longitudinal cohort data.
Background: Of patients, 30% with RA have lumbar scoliosis. However, the effectiveness of current treatment methods in preventing the progression of scoliosis is not well understood due to a lack of longitudinal studies.
Patients and methods: We enrolled 180 patients with RA who were followed up for over 2 years, all of whom underwent standing spinal x-rays. These patients were categorized based on their disease activity score-28 with erythrocyte sedimentation rate into 2 groups: (1) those in remission (n = 76) and (2) those in nonremission (n = 104). We evaluated various radiographic measures, including C7 center sacral vertical line, pelvic obliquity, major Cobb angle, and curve location.
Results: Fifty-three (29.4%) patients presented progression of scoliosis during a mean follow-up period of 4.8 years. Patients in the nonremission showed larger Cobb angle at baseline and final follow-up, compared with those in remission. The annual progression rate of the curve was also greater in the nonremission group (1.04°/yr) than in the remission group (0.59°/yr, P = 0.001). There was no difference in the incidence of new vertebral fractures. The presence of a baseline Cobb angle of 10° or more [odds ratio (OR): 3.14; 95% CI: 1.38-7.13; P = 0.006], glucocorticoid use (OR: 2.88; 95% CI: 1.18-7.06; P = 0.021), and nonremission at baseline (OR: 2.83; 95% CI: 1.25-6.41; P = 0.012) were significant risk factors for progression of scoliosis.
Conclusion: RA disease activity is linked to the progression of scoliosis in patients with RA. Patients with RA who present with initial scoliosis of ≥10°, require glucocorticoids for treatment and are in nonremission at baseline may be at high risk for scoliosis progression.
期刊介绍：
Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store.
Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
