Spondylarthritis: the frequency of fractures of the spine is lower than expected

A five-year observational study by French researchers shows a lower incidence of spine fractures at the onset of ankylosing spondylitis than observed in previous studies. Good news

French rheumatology researchers have studied the future of patients suffering from spinal pain with a diagnosis of spondyloarthritis in order to identify the factors of appearance and evolution of the disease.

Their findings challenge the results of previous studies that showed a higher frequency of fractures. This observation comes in parallel with an improvement in the management of the disease with better monitoring and more powerful treatments. Their results were published in Annals of the Rheumatic Diseases.

A study over 5 years

Researchers used X-rays of 432 people who are part of clinical research on patients with inflammatory back pain that may be associated with ankylosing spondylitis, called the DESIR cohort (Becoming undifferentiated spondyloarthropathies). "We evaluated the prevalence (total frequency - ndl) and incidence (frequency of new cases - ndl) vertebral fractures and vertebral deformities of these patients at the beginning and over 5 years," the researchers said.

In the end, only 5 patients suffered a fracture of the spine with seven vertebrae affected, most of them located at the level of the thoracic spine. For 19 other patients, the diagnosis of vertebral fracture was "doubtful" while 13 others had a prevalence of vertebral fracture.

Prevalence lower than those reported in previous studies

"We found low prevalence and incidence of fracture of the spine," the researchers conclude. "This confirms our hypothesis that the true prevalence and incidence of vertebral fracture in people with AS is lower than that reported in previous studies."

Ankylosing spondylitis may be manifested initially by severe spinal pain occurring mainly at night and in the morning after waking, without radiological lesions. When the pain is resistant to at least two effective dose anti-inflammatory treatments, anti-TNF treatment must be followed which limits the intensity and extent of the inflammatory reaction during rheumatic attacks and, most place the sick in remission.

The importance of early consultation

The diagnosis of ankylosing spondylitis should be early to allow rapid management that will relieve pain and avoid complications. Generally, the medical assessment will be accompanied by a blood test and a radiology to look for any lesions. The best is then to consult a rheumatologist because although radiology does not detect the disease, it does not mean that it is not present.

Video: MRI Use in Spondyloarthritis (November 2019).