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Updated: Jun 26, 2025
Cell-based Assay Protocol for the Prognostic Prediction of Idiopathic Scoliosis Using Cellular Dielectric Spectroscopy
Published on: October 16, 2013
Active Rheumatoid Arthritis and Scoliosis: A Mid-Term Cohort Study
Shintaro Honda1, Koichi Murata1,2, Bungo Otsuki1
1Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, Japan.
Study Design:
Retrospective cohort study.
Objective:
To elucidate the factors related to the progression of scoliosis in patients with rheumatoid arthritis (RA) using longitudinal cohort data.
Background:
Of patients, 30% with RA have lumbar scoliosis. However, the effectiveness of current treatment methods in preventing the progression of scoliosis is not well understood due to a lack of longitudinal studies.
Patients And Methods:
We enrolled 180 patients with RA who were followed up for over 2 years, all of whom underwent standing spinal x-rays. These patients were categorized based on their disease activity score-28 with erythrocyte sedimentation rate into 2 groups: (1) those in remission (n = 76) and (2) those in nonremission (n = 104). We evaluated various radiographic measures, including C7 center sacral vertical line, pelvic obliquity, major Cobb angle, and curve location.
Results:
Fifty-three (29.4%) patients presented progression of scoliosis during a mean follow-up period of 4.8 years. Patients in the nonremission showed larger Cobb angle at baseline and final follow-up, compared with those in remission. The annual progression rate of the curve was also greater in the nonremission group (1.04°/yr) than in the remission group (0.59°/yr, P = 0.001). There was no difference in the incidence of new vertebral fractures. The presence of a baseline Cobb angle of 10° or more [odds ratio (OR): 3.14; 95% CI: 1.38-7.13; P = 0.006], glucocorticoid use (OR: 2.88; 95% CI: 1.18-7.06; P = 0.021), and nonremission at baseline (OR: 2.83; 95% CI: 1.25-6.41; P = 0.012) were significant risk factors for progression of scoliosis.
Conclusion:
RA disease activity is linked to the progression of scoliosis in patients with RA. Patients with RA who present with initial scoliosis of ≥10°, require glucocorticoids for treatment and are in nonremission at baseline may be at high risk for scoliosis progression.
Level Of Evidence:
Level III.
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