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Incidence of and risk factors for spondylolisthesis, scoliosis, and vertebral fracture in rheumatoid arthritis

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Journal of Bone and Mineral Metabolism Aims and scope Submit manuscript

Abstract

Introduction

Although lumbar lesions such as spondylolisthesis, scoliosis, and vertebral fracture are not specific to rheumatoid arthritis (RA), the prevalence is high in RA patients. However, no longitudinal study has evaluated lumbar lesions in RA. This study aimed to investigate the incidence of and risk factors for lumbar lesions in RA by a prospective longitudinal cohort study.

Materials and methods

The study cohort comprised 110 patients with RA from the ‘analysis of factors for RA spinal disorders (AFFORD)’ study who completed the secondary survey at a single orthopaedic outpatient RA clinic. Radiological examination included standing radiographs and magnetic resonance imaging (MRI) of the lumbar spine. New development of spondylolisthesis, scoliosis, and vertebral fracture were assessed between baseline and secondary survey.

Results

The incidences of spondylolisthesis, scoliosis, and vertebral fracture were 42%, 16%, and 12%, respectively, during a mean follow-up of 7 years. The independent risk factor for de novo scoliosis was poor control of RA (adjusted odds ratio [aOR] 4.81, p = 0.011), while the independent risk factors for new vertebral fracture was use of glucocorticoid at secondary survey (aOR 14.87, p = 0.012). Patients with de novo scoliosis exhibited more severe low back pain and lower quality of life than those without.

Conclusion

The incidence of scoliosis was related in patients with poor control of RA, while new vertebral fracture was more common in patients with use of glucocorticoid. Control of disease activity might be important in preventing radiological lumbar disorders in RA.

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Data availability

The clinical registration number of this trial is University Hospital Medical Information Network (UMIN) 000000980.

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Acknowledgements

The authors wish to thank Atsuko Kamiyama, Tomoko Nakatsuka, and the members of the center for clinical research and innovation of Osaka City University Hospital, for their special assistance with data collection and management.

Funding

This study has no funding support.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, PL Hospital, 2204, Shindo, Tondabayashi City, Osaka, 584-8585, Japan

    Kentaro Yamada

  2. Department of Orthopaedic Surgery, Osaka City University, Osaka City, Osaka, Japan

    Kentaro Yamada, Akinobu Suzuki, Shinji Takahashi, Kentaro Inui, Tadashi Okano, Akito Yabu, Yusuke Hori, Hiromitsu Toyoda & Hiroaki Nakamura

  3. Center for Senile Degenerative Disorders (CSDD), Osaka City University, Osaka City, Osaka, Japan

    Tatsuya Koike

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Contributions

Conception and design: KY and AS. Acquisition of data: KY, AS, ST, KI, TK, TO, AY, YH, and HT. Analysis and interpretation of data: KY and ST. Drafting the article: KY. Critically revising the article: AS, TK, and HN. Reviewed submitted version of manuscript: AS, TK, and HN. Approved the final version of the manuscript on behalf of all authors: KY, AS, ST, KI, TK, TO, AY, YH, HT, and HN. Statistical analysis: KY and ST. Administrative/technical/material support: KI and TK. Study supervision: HN.

Corresponding author

Correspondence to Kentaro Yamada.

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Conflict of interest

Akinobu Suzuki received speaking fees and/or research grants from Janssen Pharmaceutical, Daiichi Sankyo Co., Ltd., Eli Lilly Japan, Asahi Kasei Pharma, Hisamitsu Pharmaceutical Co., Inc., Jansen Pharmaceutical K.K., Nuvasive Japan, Stryker Japan K.K., Medtronic Japan Co., Ltd., and Japan Society for Promotion of Science. Kentaro Inui has received speaker fees and/or research grants from Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Abbvie GK, Takeda Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Ono Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Pfizer Japan Inc., Eisai Co., Ltd., Eli Lilly Japan K.K., Novartis, and UCB. Tatsuya Koike received research fees, consulting fees, or other remuneration from AbbVie, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Eli Lilly, Mitsubishi Tanabe Pharma Co., Pfizer, Takeda Pharmaceutical Co. Ltd.,, Daiichi Sankyo K.K, Teijin Pharma, Yamada Bee Farm, Medac, GlaxoSmithKline plc, and Gilead Science Inc. Tadashi Okano has received speaking fees and/or research grants from Asahi Kasei, Astellas, Abbvie, Ayumi, Celgene, Chugai, Daiichi Sankyo, Eisai, Eli Lilly, Janssen, Mitsubishi Tanabe, Novartis, Ono, Pfizer, Sanofi, Takeda, Taisho Toyama, and Teijin. Hiroaki Nakamura has received speaker fees and/or research grants from Taisho Toyama Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd, Shionogi Co., Ltd, Eli Lilly Japan K.K, Hisamitsu Pharmaceutical Co. Ltd., and Japan Society for Promotion of Science. The other authors have no conflicts of interest.

Ethical approval

This study was approved by the Institutional Review Board of Osaka City University (No. 1189, approval date: September 13, 2007).

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Yamada, K., Suzuki, A., Takahashi, S. et al. Incidence of and risk factors for spondylolisthesis, scoliosis, and vertebral fracture in rheumatoid arthritis. J Bone Miner Metab 40, 120–131 (2022). https://doi.org/10.1007/s00774-021-01261-y

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