MEASUREMENT OF SPINAL FUSION IN ANKYLOSING SPONDYLITIS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 脊柱融合是强直性脊柱炎（AS）的临床、影像学和病理学标志。 然而，脊柱融合在AS中发生缓慢。 连续X线片很少显示超过2年的变化，通常需要5年或更长时间才能显示脊柱融合的进展。 需要比X线平片对脊柱融合程度变化更敏感的方法来测试是否有任何治疗可以减缓或停止AS的脊柱融合。 现在有几种新的药物有可能显着减少AS的脊柱炎症，因此需要改进脊柱融合术。 本初步研究的目的是测试通过计算机断层扫描（CT）测量腰椎间盘间隙纤维环处的骨矿物质密度、骨体积或骨量是否可以为AS患者的脊柱融合提供可靠、有效和灵敏的测量。 25名受试者将在基线、12个月和24个月时进行腰椎CT扫描和脊柱X线检查，并在基线和12个月时进行腰椎磁共振成像。 此外，在24个月研究期间，将每4个月进行一次临床评估。 方案中未提供治疗。 在第一个研究年内不允许使用抗肿瘤坏死因子药物治疗，但对参与者可能接受的治疗没有其他限制。 将在基线扫描的重复测量上测试图像处理的可靠性。 将通过CT测量值与平片、腰椎磁共振成像和脊柱活动度评分的相关性来检验结构有效性。 将比较12个月和24个月内CT测量值变化的敏感性与基于平片的两种评分系统的敏感性。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Spinal fusion is the clinical, radiological, and pathological hallmark of ankylosing spondylitis (AS). However, spinal fusion occurs slowly in AS. Serial radiographs rarely show changes over 2 years, and often 5 or more years are needed to demonstrate progression of spinal fusion. Methods that are more sensitive to changes in the extent of spinal fusion than plain radiographs are needed to test if any treatments can slow or halt spinal fusion in AS. The need for an improved measure of spinal fusion is heightened now that several new medications are available that have the potential to markedly decrease spinal inflammation in AS. The goal of this pilot study is to test whether measurement of bone mineral density, bone volume, or bone mass at the annulus fibrosis of lumbar disc spaces by computed tomography (CT) can provide a reliable, valid, and sensitive measure of spinal fusion in patients with AS. Twenty-five participants will have lumbar spine CT scans and spinal radiographs at baseline, 12 months, and 24 months, and lumbar spine magnetic resonance imaging at baseline and 12 months. In addition, clinical assessments will be done every 4 months during the 24-month study. No treatment is provided in the protocol. Treatment with anti-tumor necrosis factor medications is not permitted during the first study year, but there are no other restrictions on the treatments participants may receive. Reliability of image processing will be tested on repeated measurements of baseline scans. Construct validity will be tested by correlation of CT measures with scores of plain radiographs, lumbar magnetic resonance imaging, and spinal range of motion. The sensitivity to change of the CT measures over 12 months and 24 months will be compared to those of two scoring systems based on plain radiographs.