Risk Factors for Spinal Structural Damage in a Chinese Cohort With Ankylosing Spondylitis

Area of Science:

• Rheumatology
• Orthopedics
• Radiology

Background:

• Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine.
• Spinal structural damage is a major cause of disability in AS patients.
• Identifying risk factors for spinal damage is crucial for early intervention.

Purpose of the Study:

• To identify potential risk factors associated with the severity of spinal structural damage in Chinese patients with ankylosing spondylitis (AS).
• To develop a predictive model for spinal structural damage in AS.

Main Methods:

• A cross-sectional study involving 270 Chinese AS patients.
• Modified New York Criteria for AS diagnosis.
• Computed tomography (CT) and radiography for spinal and joint imaging.
• Assessment of spinal structural damage using the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS).

Main Results:

• Seven factors significantly associated with high mSASSS: age of onset, BMI, smoking duration, symptom duration, diagnostic delay, hip involvement, and sacroiliitis grade.
• Hip involvement interacted with BMI and smoking duration.
• High BMI and hip involvement increased the risk of severe spinal damage by 5.07-fold.

Conclusions:

• Seven potential risk factors for severe spinal structural damage in Chinese AS patients were identified.
• Positive hip involvement, particularly with high BMI or long smoking duration, is a significant risk factor for severe spinal damage.
• A predictive nomogram was developed with high accuracy (concordance index, 0.906).