Vascular disease is associated with facet joint osteoarthritis

Suri, P.; Katz, J.N.; Rainville, J.; Kalichman, L.; Guermazi, A.; Hunter, D.J.

doi:10.1016/j.joca.2010.06.012

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Volume 18, Issue 9 , Pages 1127-1132, September 2010

Vascular disease is associated with facet joint osteoarthritis

P. Suri
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- New England Baptist Hospital, Boston, MA, USA
- Spaulding Rehabilitation Hospital, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
- Address correspondence and reprint requests to: Pradeep Suri, Division of Research, New England Baptist Hospital, 125 Parker Hill Ave Boston, MA 02130, USA. Tel: 1-617-5754-5675; Fax: 1-617-754-6888.
J.N. Katz
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Orthopedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
J. Rainville
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- New England Baptist Hospital, Boston, MA, USA
L. Kalichman
- New England Baptist Hospital, Boston, MA, USA
- Department of Physical Therapy, Ben-Gurion University of the Negev, Beer Sheva, Israel
A. Guermazi
- Boston University School of Medicine, Boston, MA, USA
D.J. Hunter
- New England Baptist Hospital, Boston, MA, USA
- Northern Clinical School, The University of Sydney, Sydney, New South Wales, Australia

Received 12 March 2010; accepted 28 June 2010. published online 14 July 2010.

Summary

Objective

Epidemiologic studies have demonstrated associations between vascular disease and spinal degeneration. We sought to examine whether vascular disease was associated with lumbar spine facet joint osteoarthritis (FJ OA) in a community-based population.

Design

441 participants from the Framingham Heart Study multi-detector computed tomography (MDCT) Study were included in this ancillary study. We used a quantitative summary measure of abdominal aortic calcification (AAC) from the parent study as a marker for vascular disease. AAC was categorized into tertiles of ‘no’ (reference), ‘low’, and ‘high’ calcification. FJ OA was evaluated on computerised tomography (CT) scans using a four-grade scale. For analytic purposes, FJ OA was dichotomized as moderate FJ OA of at least one joint from L2–S1 vs no moderate FJ OA. We examined the association of AAC and FJ OA using logistic regression before and after adjusting for age, sex and body mass index (BMI). Furthermore, we examined the independent effect of AAC on FJ OA after including the known cardiovascular risk factors; diabetes, hypertension, hypercholesterolemia, and smoking.

Results

Low AAC (OR 3.84 [2.33–6.34]; P≤0.0001) and high AAC (9.84 [5.29–18.3]; ≤0.0001) were strongly associated with FJ OA, compared with the reference group. After adjusting for age, sex, and BMI, the association with FJ OA was attenuated for both low AAC (1.81 [1.01–3.27]; P=0.05) and high AAC (2.63 [0.99–5.23]; P=0.05). BMI and age were independently and significantly associated with FJ OA. The addition of cardiovascular risk factors to the model did not substantially change parameter estimates for either AAC tertile.

Conclusions

AACs were associated with FJ OA in this community-based population, when adjusting for epidemiologic factors associated with spinal degeneration, and cardiovascular risk factors. Potentially modifiable risk factors for facet degeneration unrelated to conventional biomechanical paradigms may exist. This study is limited by cross-sectional design; longitudinal studies are needed.

Keywords: Osteoarthritis, Facet, Zygapophyseal, Vascular diseases, Calcification, Risk factors