Abstract
Background
Cross-sectional studies on diffuse idiopathic skeletal hyperostosis have focused on
its incidence and related factors. However, the long-term changes caused by the disease
remain unclear. This longitudinal cohort study aimed to elucidate the progression
of diffuse idiopathic skeletal hyperostosis and its effects on physical function,
health-related quality of life, and spinal alignment.
Methods
We recruited 255 older adults (87 men and 168 women; average age, 71.3 years in 2014)
who attended local health checkups in 2014 and 2020. Height, body weight, body mass
index, blood pressure, grip strength, functional reach, and bone mineral density were
measured. The prevalence, location, number of ossified contiguous vertebrae, and spinopelvic
parameters were estimated using whole-spine standing radiographs. For health-related
quality of life assessment, the Oswestry disability index and EuroQuol-5D were obtained.
We performed a 1:1 case-control study with age and sex-matched patients with and without
diffuse idiopathic skeletal hyperostosis and analyzed progression over a 6-year period.
Results
In 2014, 39 (15.3%) of 255 patients were diagnosed with diffuse idiopathic skeletal
hyperostosis (24 males and 15 females), which occurred more frequently in the elderly
and males. In 2020, 12 (4.3%) patients were newly diagnosed with diffuse idiopathic
skeletal hyperostosis, and 28 (71.7%) of 39 patients diagnosed in 2014 showed varying
degrees of progression. Compared with age- and sex-matched patients without diffuse
idiopathic skeletal hyperostosis, patients with the condition had higher body mass
index and lumbar bone mineral density, larger sagittal vertical axis, and greater
T1-pelvic angle. Changes in physical function and spinal-pelvic parameters during
the 6-year period did not differ between the groups.
Conclusions
Over a 6-year period, the prevalence of diffuse idiopathic skeletal hyperostosis increased
by 4.3%, and it progressed in 71.7% of patients. However, it had little effect on
longitudinal physical function, health-related quality of life, and spinopelvic parameters
in older adults.
Keywords
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Article info
Publication history
Published online: January 18, 2023
Accepted:
December 22,
2022
Received in revised form:
December 20,
2022
Received:
October 7,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
