Cervical Facet Joint Ankylosis in Patients With Axial Spondyloarthritis Serves as a Surrogate Radiographic Indicator of Propensity for Bone Formation

IF 2 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases Pub Date : 2025-08-25 DOI:10.1111/1756-185x.70406

In-Woon Baek, Seung Min Jung, Yun-Jung Park, Kyung-Su Park, Ki-Jo Kim

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Abstract

Objective

To investigate the involvement of facet joints and its clinical implications during the treatment course in patients with axial spondyloarthritis (axSpA).

Methods

This was a retrospective observational study. Radiographs of the cervical and lumbar spine were evaluated for 799 patients with axSpA using the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and the de Vlam methods. Differences in radiographic progression indices and initiation of TNF inhibitors between patients with and without facet joint fusion were investigated using propensity score matching.

Results

Facet joint involvement at the cervical spine was observed in a subset of patients with axSpA (20.6%). Patients with facet joint fusion (n = 71) had higher mSASSS and a higher number of syndesmophytes at both cervical and lumbar levels compared with the matched patients without facet joint fusion. Dagger signs and trolley-track signs were more commonly observed (p < 0.001), and trolley-track signs developed more frequently in patients with facet joint fusion during follow-up (Δ9/49 vs. Δ1/68, p = 0.0038). Disease activity score and CRP level at baseline were also significantly higher in patients with facet joint fusion. The risk of initiation of TNF inhibitor was significantly higher in patients with facet joint fusion (hazard ratio [95% CI] 1.909 [1.187, 3.07], p = 0.007).

Conclusions

Facet joint involvement in the cervical spine was identified in a subset of patients with axSpA and was closely associated with advanced radiographic structural damage and the initiation of TNF inhibitors.

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轴性脊柱炎患者的颈椎小关节强直可作为骨形成倾向的替代放射学指标

目的探讨轴型脊柱炎（axSpA）患者治疗过程中关节突关节受累情况及其临床意义。方法回顾性观察性研究。采用改良的Stoke强直性脊柱炎脊柱评分（mSASSS）和de Vlam方法对799例axSpA患者的颈椎和腰椎x线片进行评估。采用倾向评分匹配法研究了有和没有小关节融合的患者在影像学进展指数和TNF抑制剂启动方面的差异。结果部分axSpA患者（20.6%）出现颈椎小关节受累。与没有小关节融合的患者相比，小关节融合患者（n = 71）在颈椎和腰椎水平有更高的mSASSS和更多的联合骨刺。匕首征象和小车轨道征象更常见（p < 0.001），小车轨道征象在小关节融合患者随访期间更频繁出现（Δ9/49 vs. Δ1/68, p = 0.0038）。小关节融合术患者的疾病活动度评分和CRP基线水平也显著升高。小关节融合患者启动TNF抑制剂的风险明显更高（风险比[95% CI] 1.909 [1.187, 3.07], p = 0.007）。结论：一小部分axSpA患者存在颈椎小关节受累性，并与晚期影像学结构损伤和TNF抑制剂的启动密切相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Rheumatic Diseases RHEUMATOLOGY-

CiteScore

3.70

自引率

4.00%

发文量

362

审稿时长

1 months

期刊介绍： The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.