Paraspinal muscle fibrosis: a specific pathological component in ankylosing spondylitis

Article Abstract:

The paraspinal muscles surround the backbone, and their adjustments from second to second are important in maintaining posture. Studies of whether paraspinal muscles are affected in ankylosing spondylitis, a rheumatic disease in which the vertebrae eventually fuse, have been uncommon. It is important to determine whether the muscles are altered during the disease, as physical therapy for the condition is often directed at improving back strength and mobility. Specimens obtained from paraspinal muscles of 8 men with ankylosing spondylitis were compared with those of 13 patients with spinal immobility and disability due to mechanical back pain. Half the patients with spondylitis were in early stages while half were in late stages of the disease. Although both groups were of similar ages, patients with spondylitis had experienced back symptoms for a longer duration. Type II muscle fibers, whose contractions are associated with prolonged activities, were selectively atrophied in both groups, but whether this was due to simple pain-related disuse or to inflammation-related reflex inhibition was unclear. Fatty infiltration, present in both groups, was more marked in patients with spondylitis, and fibrous connective tissue infiltration was also clearly present in these patients as well. The nuclei within paraspinal muscles had moved centrally, a feature of numerous myopathies (muscle diseases). The results suggest that ankylosing spondylitis may be associated with generalized paraspinal muscle atrophy with fibrosis, thus decreasing back strength and hampering therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Ankylosing spondylitis: an autoimmune disease?

Article Abstract:

Ankylosing spondylitis is a rheumatic disorder chiefly involving the spine that is difficult to diagnose in the early stages, partly due to the absence of autoantibodies usually found rheumatic in diseases. (Autoantibodies are inappropriately directed against the body's own molecules.) If a spondylitis-specific blood test for autoantibodies or other molecules could be developed, early diagnosis of the disease would be facilitated. Earlier research suggested that antibodies from patients with ankylosing spondylitis were reactive against heat shock and other proteins derived from drosophila (fruit flies). This is similar to autoantibodies in other rheumatic diseases which appear to react against bacterial molecules. The reactivity of antibodies in blood samples from 95 patients with definite spondylitis, 43 with suspected disease, 29 patients with rheumatoid arthritis, 45 patients with spondylarthropathies (arthritis involving the spine) and 38 healthy control subjects. Antibodies against a drosophila protein were present in 34 percent of patients with definite spondylitis, 28 percent with suspected spondylitis, 44 percent of patients with spondylarthropathy related to ankylosing spondylitis, and absent in rheumatoid arthritics and control subjects. The antibody was not related to the presence of HLA-B27, an immune molecule associated with an increased risk for spondylitis. The antibody reacted against proteins from human cells, indicating that it was an autoantibody. Further study should aid in use of this antibody as a diagnostic tool for spondylarthropathies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Autoantibodies, Identification and classification

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Understanding paraspinal muscle dysfunction in low back pain: a way forward?

Article Abstract:

Chronic low back pain may be associated with paraspinal muscle dysfunction in some patients. Paraspinal muscle dysfunction is impaired function of the muscles that surround the spine. The paraspinal muscles provide the spine with stability and protect it from damage. These muscles are weak and tire easily in patients who have paraspinal muscle dysfunction. This type of dysfunction may be caused by decreased use of these muscles in some patients. An alternative is that low back pain precedes the development of paraspinal muscle dysfunction. Patients with low back pain may not use these muscles because they are afraid of pain. Identifying the cause of paraspinal muscle dysfunction may help in the treatment of patients with chronic back pain. Chronic low back pain can cause serious physical and emotional problems, especially when it is resistant to treatment.

Column, Causes of, Muscles, Backache, Back pain

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