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Increased Spinal Involvement with Duration and Severity of Ankylosing Spondylitis

The risk of spinal involvement in patients with ankylosing spondylitis increases with disease severity and duration.

Previous studies have shown that spondyloarthropathies in the North African population are more severe and are characterised by more frequent hip involvement. Patients with ankylosing spondylitis (AS) also have an increased risk of atlantoaxial subluxation cervical spine fractures and cervical spinal stenosis.

A. El Maghraoui with the Military Hospital Mohamed V, Rabat, Morocco, and colleagues sought to determine the incidence of clinical and radiological cervical spine involvement in Moroccan patients with AS.

X-rays of the pelvis, lumbar and cervical spine were evaluated for 61 patients between the ages of 17 and 66 that were diagnosed with AS during a 1 year recruitment period.

Within these patients, 70.4% had a history of inflammatory neck pain with a limited range of motion as assessed by clinical examination. Radiological evidence showed involvement in 54%.

Risk of cervical spine involvement increased with disease duration and severity. Specifically, 19.6% of patients had radiological involvement after 5 years, 29.9% after 10 years, 45.1% after 15 years and 70.0% after 20 years.

Patients with cervical spine involvement had a more severe disease as determined by high Bath Ankylosing Spondylitis Metrology, Functional, Disease Activity, and Global Index Scores.

Dr. El Maghraoui notes that this study "confirms the greater severity of AS in North African countries". Furthermore, "cervical spine involvement increases with age and disease duration and is more frequent in symptomatic and structural severe forms of the disease."
Clin Rheumatol 2003;22:2:94-98. "Cervical spine involvement in ankylosing spondylitis"

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