Background Ankylosing spondylitis produces a progressive decrease in spinal mobility with the evolution of the disease. This decrease is due to inflammation and structural damage at radiological level that occurs in neck and spine. Several indices have been validated to quantify this grade of affectation. The most used index to assess structural damage is the mSASSS. This index is evaluated between 0 to 72 points and it measures equally the affectation grade of the neck and lower back. Recently a new index based on motion analysis has been defined wich produces accurate and objective information about mobility, the UCOASMI  index. For calculating this index, two cervical mobility and three lumbar mobility measures are used, so cervical UCOASMI and lumbar UCOASMI can be defined. With the evolution of the disease UCOASMI and mSASSS indexes increases with more structural damage and loss of mobility, but what is the relation between lumbar and cervical damage with the evolution of AS?
Objectives To analyze the evolution of AS in terms of radiological damage and mobility at the cervical and lumbar area.
Methods 76 patients diagnosed with AS (75% male, age 44.1±11.5 years, duration 13.6±9.4 years) were analyzed. A radiologist assessed radiographs for calculating mSASSS. At the Motion Analysis Laboratory of the Reina Sofia University Hospital, UCOTrack system was used to calculate UCOASMI index. For both indices, coefficient cervical/lumbar ratio was calculated to identify which part was more affected.
Results Table shows affectation grade in mobility (UCOASMI) and radiographic damage (mSASSS) in total sample and grouped by gender, duration, and affectation grade in mobility. Differences between groups are also showed indicating whether these are statistically significant.
Conclusions The relation between affectation of cervical and lumbar part seems to be balanced around 50% according to both structural damage and mobility. Mobility differences in genre were not appreciated. While there are differences in the structural damage between male and female, this difference appears similarly in both areas. According to our results, only at initial stages of the disease, lower back is most affected, especially as far as mobility is concerned.
Garrido-Castro JL, Escudero A, Medina-Carnicer R, Galisteo AM, Gonzalez-Navas C, Carmona L, Collantes-Estevez E. Validation of a new objective index to measure spinal mobility: the University of Cordoba Ankylosing Spondylitis Metrology Index (UCOASMI). Rheumatol Int. 2013 Dec 20. [Epub ahead of print]
Disclosure of Interest : None declared
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