Photo Credit: angkhan

The following is a summary of “Burden of Spine Structural Damage on Function in Patients With Axial Spondyloarthritis: Adaptation-Mediated Uncoupling?,” published in the August 2024 issue of Rheumatology by Penteado et al.

Researchers conducted a retrospective study examining the relationship between spinal damage and functional capacity in patients with axial spondyloarthritis (axSpA) and to compare the effectiveness of 2 radiographic scoring systems, the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and the Combined Ankylosing Spondylitis Spine Score (CASSS).

They evaluated radiographs from 101 patients with axSpA for cervical facet joint (CFJ) damage and vertebral body damage using the modified mSASSS. The CASSS was derived as the total of the 2 scores. Physical function was measured using the Bath Ankylosing Spondylitis Functional Index (BASFI), disease activity was assessed with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS), mobility was evaluated using the Bath Ankylosing Spondylitis Metrology Index (BASMI), and QoL was gauged with the Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire. Univariate and multivariate analyses were conducted to explore the relationships between the variables and the measured outcomes.

The result showed BASFI strongly correlated with ASQOL (ρ 0.66) and BASDAI (ρ 0.70), moderately with BASMI (ρ 0.46) and ASDAS (ρ 0.59), and weakly with mSASSS (ρ 0.29) and CASSS (ρ 0.28). In a model adjusting for symptom duration, age, sex, and smoking status, BASDAI (B 0.76, P<0.001), BASMI (B 0.62, P<0.001), and history of total hip arthroplasty (B 1.22, P=0.05) were key BASFI predictors. Radiographic scores only predicted BASFI when BASMI was excluded (mSASSS: B 0.03, P=0.01; CASSS: B 0.02, P=0.01).  

Investigators concluded that while spinal damage independently impacted physical function in axSpA, the effect was less significant than disease activity and mobility, and adding CFJ assessment to mSASSS did not enhance functional prediction.

Source: jrheum.org/content/51/8/765