• Title/Summary/Keyword: ankylosing

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Management of Andersson Lesion in Ankylosing Spondylitis Using the Posterior-Only Approach: A Case Series of 18 Patients

  • Shaik, Ismail;Bhojraj, Shekhar Yeshwant;Prasad, Gautam;Nagad, Premik Bhupendra;Patel, Priyank Mangaldas;Kashikar, Aaditya Dattatreya;Kumar, Nishant
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1017-1027
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    • 2018
  • Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

Association of Congestive Heart Failure and Death with Ankylosing Spondylitis : A Nationwide Longitudinal Cohort Study in Korea

  • Bae, Ki Hwan;Hong, Je Beom;Choi, Yoon Jin;Jung, Jin Hyung;Han, In-Bo;Choi, Jung Min;Sohn, Seil
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.217-224
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    • 2019
  • Objective : We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death. Methods : We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities. Results : During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p<0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p<0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80-2.89) and 1.66 (95% CI, 1.42-1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups. Conclusion : The incidence rates of congestive heart failure and death were increased in AS patients.

A Meta-analysis for the Effects of Exercise on Pulmonary Function in Patients with Ankylosing Spondylitis (강직성 척추염 환자의 폐기능에 미치는 운동효과에 대한 메타분석)

  • Kim, Eun-Jeong;Lee, Eun-Nam;Yu, Eun-Jeong
    • Journal of muscle and joint health
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    • v.26 no.2
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    • pp.141-154
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    • 2019
  • Purpose: This study aimed to analyze the effects of exercise on pulmonary function in patients with ankylosing spondylitis (AS). Methods: Randomized controlled trials (RCTs) were identified by searching MEDLINE, EMBASE, CENTRAL, and CINAHL (through Jan 2019). Three reviewers independently retrieved articles, extracted data, and assessed methodological quality using the Cochrane's Risk of Bias for randomized studies. Results: Fourteen studies met the inclusion criteria with a total of 729 participants. CE (SMD 0.58, 95% CI 0.41~0.75, p<.001) and $VO_2peak$ (SMD 0.56, 95% CI 0.24~0.88, p=.001) had a significant effect on the most exercise interventions. As a secondary variable, BASFI (SMD -0.53, 95% CI -0.70~-0.37, p<.001), BASMI (SMD -0.75, 95% CI -0.92~-0.58, p<.001) showed an effect size of more than medium. However, PFT and QoL did not produce a significant results. Conclusion: Pulmonary involvement is common in patients with AS and might have disturbed functionality and exercise modality. Exercise can be an effective intervention to improve pulmonary function in patients with AS. More attention is needed to improve the chest and spinal mobility to maintain the appropriate pulmonary function. It is also necessary to consider how to construct a patient-tailored exercise program to increase performance, accuracy and safety of exercise.

The Molecular Mechanism of Long Non-Coding RNA MALAT1-Mediated Regulation of Chondrocyte Pyroptosis in Ankylosing Spondylitis

  • Chen, Wei;Wang, Feilong;Wang, Jiangtao;Chen, Fuyu;Chen, Ting
    • Molecules and Cells
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    • v.45 no.6
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    • pp.365-375
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    • 2022
  • Long non-coding RNAs (lncRNAs) may be important regulators in the progression of ankylosing spondylitis (AS). The competing endogenous RNA (ceRNA) activity of lncRNAs plays crucial roles in osteogenesis. We identified the mechanism of the differentially expressed lncRNA MALAT1 in AS using bioinformatic analysis and its ceRNA mechanism. The interaction of MALAT1, microRNA-558, and GSDMD was identified using integrated bioinformatics analysis and validated. Loss- and gain-of-function assays evaluated their effects on the viability, apoptosis, pyroptosis and inflammation of chondrocytes in AS. We found elevated MALAT1 and GSDMD but reduced miR-558 in AS cartilage tissues and chondrocytes. MALAT1 contributed to the suppression of cell viability and facilitated apoptosis and pyroptosis in AS chondrocytes. GSDMD was a potential target gene of miR-558. Depletion of MALAT1 expression elevated miR-558 by inhibiting GSDMD to enhance cell viability and inhibit inflammation, apoptosis and pyroptosis of chondrocytes in AS. In summary, our key findings demonstrated that knockdown of MALAT1 served as a potential suppressor of AS by upregulating miR-558 via the downregulation of GSDMD expression.

Treatment of Ankylosing Spondylitis (강직성 척추염의 치료)

  • Kang, Byeong-Jik;Jo, Sung-Sin;Park, Ye-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.294-304
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    • 2021
  • Ankylosing spondylitis causes ankylosis of the spine due to ossification of the articular cartilage and ligaments around the vertebral body as well as the sacroiliac joint. This pathophysiology limits joint movement and, in many cases, causes pain and deformity of the spine. If this disease is left untreated, it ultimately causes ankylosis and ossification of the whole-body joints. The symptoms generally develop before age 30 years, and the gradual progression of the disease adversely affects the physical function, professional ability, and quality of life. This increases the likelihood of developing psychiatric disorders, such as depression. The authors are aware of this severity and introduce recent trends and studies to prevent surgical treatment with various medications before systemic ossification. This paper presents various surgical treatments and complications in patients who were unable to prevent progression and underwent surgical treatment.

Cauda Equina Syndrome Associated with Dural Ectasia in Chronic Anlylosing Spondylitis

  • Ha, Sang-Woo;Son, Byung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.517-520
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    • 2014
  • Cauda equina syndrome (CES) associated with dural ectasia is a rare neurologic complication in patients with longstanding ankylosing spondylitis (AS). We report a 68-year-old male with a 30-year history of AS who presented a typical symptom and signs of progressive CES, urinary incontinence and neuropathic pain of the lumbosacral radiculopathy. Computed tomography (CT) and magnetic resonance imaging (MRI) findings showed the unique appearances of dural ectasia, multiple dural diverticula, erosion of posterior element of the lumbar spine, tethering of the conus medullaris and adhesion of the lumbosacral nerve roots to the posterior aspect of the dural ectasia. Considering the progressive worsening of the clinical signs, detethering of the conus medullaris through resection of the filum terminale was performed through a limited laminectomy. However, the urinary incontinence did not improve and there was a partial relief of the neuropathic leg pain only. The possible pathogenetic mechanism of CES-AS and the dural ectasia in this patient with longstanding AS are discussed with a literature review.

A Study of Literature Review on Elbow pain (주통의 동서의학적(東西醫學的) 고찰(考察))

  • Yang, dong-won;O, min-seok;Song, tae-won
    • Journal of Haehwa Medicine
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    • v.11 no.1
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    • pp.201-215
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    • 2002
  • Objectives : Study Cause of Elbow pain. Methods : Literature Review on Elbow pain in view of oriental medicine and western medicine. Conclusions : In view of oriental medicine cause of elbow pain is yukum(六淫), Jangbu(臟腑), gunglak(經絡) and in western medicine, cause is inflammation, overworking, ankylosing, deformity, etc.

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Review of rheumatic diseases in terms of insurance medicine (주요 류머티스 질환의 보험의학적 이해)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.31 no.1
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    • pp.19-28
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    • 2012
  • Nowadays, Rheumatic diseases are increasing more and more. So, it's important knowing the pathophysiology and extra-risk of each rheumatic disease so as to do sound underwriting. Here is brief review and long-term prognosis of some rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sj$\ddot{o}$gren syndrome, antiphospholipid syndrome, systemic sclerosis, ankylosing spondylitis, Takayasu's arteritis, and Behcet syndrome.

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Etiopathogenesis of sacroiliitis: implications for assessment and management

  • Baronio, Manuela;Sadia, Hajra;Paolacci, Stefano;Prestamburgo, Domenico;Miotti, Danilo;Guardamagna, Vittorio A.;Natalini, Giuseppe;Bertelli, Matteo
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.294-304
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    • 2020
  • The sacroiliac joints connect the base of the sacrum to the ilium. When inflamed, they are suspected to cause low back pain. Inflammation of the sacroiliac joints is called sacroiliitis. The severity of the pain varies and depends on the degree of inflammation. Sacroiliitis is a hallmark of seronegative spondyloarthropathies. The presence or absence of chronic sacroiliitis is an important clue in the diagnosis of low back pain. This article aims to provide a concise overview of the anatomy, physiology, and molecular biology of sacroiliitis to aid clinicians in the assessment and management of sacroiliitis. For this narrative review, we evaluated articles in English published before August 2019 in PubMed. Then, we selected articles related to the painful manifestations of the sacroiliac joint. From the retrieved articles, we found that chronic sacroiliitis may be caused by various forms of spondyloarthritis, such as ankylosing spondyloarthritis. Sacroiliitis can also be associated with inflammatory bowel disease, Crohn's disease, gout, tuberculosis, brucellosis, and osteoarthritis, indicating common underlying etiological factors. The pathophysiology of sacroiliitis is complex and may involve internal, environmental, immunological, and genetic factors. Finally, genetic factors may also play a central role in progression of the disease. Knowing the genetic pre-disposition for sacroiliitis can be useful for diagnosis and for formulating treatment regimens, and may lead to a substantial reduction in disease severity and duration and to improved patient performance.