Background/Purpose: The aim of this double-blind, controlled, cross-sectional study is to compare the cervical vertebral structural changes of the patients with nr-axSpA, AS and control group using the mSASSS and to determine whether the cervical vertebral involvement is more early and more than the lumbar spine in the early period of the axial SpA.

Methods: A total of 205 people, 71 of whom were diagnosed as AS, 68 of whom were nr-axSpA, and 66 of them were control group were included in the study. Demographic data, CRP values, and HLA-B27 results were recorded.  BASDAİ, BASFİ, BASMİ, and MASES values were calculated at the evaluation of the patients. The presence of sacroiliitis on pelvic radiography was evaluated according to the mNY criteria. Radiological evaluation of cervical and lumbar lateral radiographs was performed according to the mSASSS system.

Results: In this study, the duration of symptoms was significantly shorter in the nr-axSpA group than in the AS group (p = 0.010). There was a statistically significant difference at total mSASSS between the AS group and the nr-axSpA group (p= 0,038) but not at cervical and lumbar mSASSS (p=0,449, p=0,460). There was a statistically significant correlation between cervical and lumbar mSASSS scores in the AS group (p: 0.038, CC: 0.248), but not in the nr-axSpA group (p: 0,115, CC: 0,194). In AS and nr-axSpA groups, cervical mSASSS scores were higher than lumbar mSASSS scores in the majority of patients (%82,8 and %89,5). Although in the AS group, the cervical and total mSASSS scores were positively correlated with the duration of symptoms (CC:0,255, CC:0,295), there was no correlation in the nr-axSpA group.

Conclusion: Although the duration of the symptoms was shorter in the nr-axSpA group than in the AS group, there was no statistically significant difference between the cervical mSASSSS scores between the AS and nr-axSpA groups. This situation may indicate that cervical vertebral changes occur in the early period of axial spondyloarthropathy. A similar statistical non-significant result was found between lumbar mSASSS scores of AS and nr-axSpA groups although not at total mSASSS.

However, there was a statistically significant correlation between cervical and lumbar mSASSS scores in the AS group and none in the nr-axSpA group. In AS and nr-axSpA group, cervical mSASSS scores were higher than lumbar mSASSS scores in the majority of patients. In contrast to our traditional knowledge, in patients with axial spondyloarthropathy cervical vertebral involvement was more prominent than lumbar vertebral involvement. This results may support our hypothesis that cervical involvement is early and more severe than the lumbar spine in the early period of the axial SpA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-the-early-cervical-structural-changes-in-patients-with-non-radiographic-axial-spondyloarthropathy/