Association between radiographic damage of the spine and spinal mobility for individual patients with ankylosing spondylitis:: can assessment of spinal mobility be a proxy for radiographic evaluation?
Association between radiographic damage of the spine and spinal mobility for individual patients with ankylosing spondylitis:: can assessment of spinal mobility be a proxy for radiographic evaluation?
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DOI：
10.1136/ard.2004.029728
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发表时间：
2005-07-01
影响因子：
27.4
通讯作者：
van der Heijde, D
中科院分区：
文献类型：
--
作者：
Wanders, A;Landewé, R;van der Heijde, D
目的：为了证明强直性脊柱炎患者脊柱活动度和影像学损害的各种措施之间的关联，并确定脊柱活动度的评估是否可以作为评估影像学损害的代理。方法：影像学损害评估的mSASSS。累积概率图将个体患者的放射学损伤评分与9项脊柱活动度测量的相应评分相结合。进行受试者操作特征分析，以确定每种脊柱活动度测量的截止水平，最好地区分存在和不存在放射学损伤。三个任意截止水平的射线损伤进行了研究。计算Likelihood比率，以进一步探索脊柱的流动性measurements.Results的诊断特性：累积概率图显示脊柱的流动性措施和放射学损伤的个别患者之间的关联。无论选择何种影像学进展的截止水平，脊柱侧弯和BASMI最能区分有和无结构性损伤的患者。即使是最好的脊柱活动度的歧视性评估错误分类相当大比例的患者（高达20%）。踝间距离表现最差（高达30%的错误分类）。脊柱侧屈最好的预测没有放射学损伤，和一个修改后的斯科贝尔测试最好的预测存在的放射学damage.Conclusion：这项研究明确地证明了脊柱的流动性和放射学损伤之间的关系。然而，脊柱活动度不能作为个体患者影像学评价的替代指标。
Objective: To demonstrate the association between various measures of spinal mobility and radiographic damage of the spine in individual patients with ankylosing spondylitis, and to determine whether the assessment of spinal mobility can be a proxy for the assessment of radiographic damage.Methods: Radiographic damage was assessed by the mSASSS. Cumulative probability plots combined the radiographic damage score of an individual patient with the corresponding score for nine spinal mobility measures. Receiver operating characteristic analysis was performed to determine the cut off level of every spinal mobility measure that discriminates best between the presence and absence of radiographic damage. Three arbitrary cut off levels for radiographic damage were investigated. Likelihood ratios were calculated to explore further the diagnostic properties of the spinal mobility measures.Results: Cumulative probability plots showed an association between spinal mobility measures and radiographic damage for the individual patient. Irrespective of the chosen cut off level for radiographic progression, lateral spinal flexion and BASMI discriminated best between patients with and those without structural damage. Even the best discriminatory spinal mobility assessments misclassified a considerable proportion of patients ( up to 20%). Intermalleolar distance performed worst ( up to 30% misclassifications). Lateral spinal flexion best predicted the absence of radiographic damage, and a modified Schober test best predicted the presence of radiographic damage.Conclusion: This study unequivocally demonstrated a relationship between spinal mobility and radiographic damage. However, spinal mobility cannot be used as a proxy for radiographic evaluation in an individual patient.