POS0981\u2005COMPUTED TOMOGRAPHY-BASED ASSESSMENT OF RADIOGRAPHIC PROGRESSION IN SPINE AND SACROILIAC JOINTS AFTER PREGNANCY IN WOMEN WITH ANKYLOSING SPONDYLITIS

Abstract

Mechanical stress are one of the pathogenesis of ankylosing spondlitis (AS). During pregnancy, the mechanical overload on the spine and pelvis increases due to gravid uterus. Recently, computed tomography syndesmophyte score (CTSS) has been developed to analysis of the spinal damage in patients with AS. Indeed, CT has higher sensitivity and reliability compared to conventional radiography in the detection of sacroiliitis.We aimed to investigate whether pregnancy and delivery affect radiographic progression of spine and SIJ in women with AS based on CT evaluation.This retrospective study included women aged 19-49 years with AS who performed at least twice CT scans of whole-spine or sacroilliac joints (SIJ) at intervals of 2 to 4 years. To compare the radiographic progression after delivery, we classified into 2 groups: delivery group or controls. Delivery group was restricted to subjects who had the first CT scans ~2 years before delivery and the second CT scans ~2 years after delivery. CTSS (0-522) and SIJ scores (0-40) were used to evaluate the spinal syndesmophyte and erosion, joint space narrowing, and sclerosis of SIJ.A total of 21 women in delivery group and 38 women in controls were included. The median (Q1-Q3) CTSS at baseline in delivery group and controls were 19 (16-23) and 20 (13.25-27.75), and median progression was 1 (0-3) and 0 (0-1) during the median 2.9 year follow-up. The median (Q1-Q3) SIJ scores at baseline in delivery group and controls were 13 (8-22) and 11 (6-22), and median progression was 1.5 (0-3) and 1 (0-2). The CTSS and SIJ scores significantly increased in both groups, but no difference in absolute score changes per time point between was observed. The changes in SIJ scores was comparable according to the delivery methods.This study suggests that pregnancy and delivery had no effect on radiographic progression of spine and SIJ in female with AS.[1]de Bruin F, de Koning A, van den Berg R, Baraliakos X, Braun J, Ramiro S. Development of the CT Syndesmophyte Score (CTSS) in patients with ankylosing spondylitis: data from the SIAS cohort. 2018;77(3):371-7.None declared.