Sacroiliac Joint Pathology in Elderly Patients with Low Back Pain (Observation Program "IOLANTA")

Pain in the lower back is one of the frequent reasons for seeking medical help among people over 60 years of age. The study of this problem is of interest to specialists of various profiles, including neurologists, rheumatologists, orthopedic surgeons and therapists. Purpose - to determine prevalence rate of sacroiliac joint pathology in elderly patients with low back pain (LBP) in conjunction with evaluation of clinical significance of bone resorption and cytokines markers. Materials and Methods. The study was conducted with consecutive inclusion of patients (n = 259) with mean age of 65.5 year old [62.5; 69.5] who addressed the hospital for the first time in calendar year with complaints for low back pain. The authors performed MRI examination of lumbar-sacral spine and sacroiliac joint, assessed transforming growth factor beta 1 (TGF beta 1), interleukin (IL) 1 beta and IL-6, Beta-Crosslaps (beta-CrossLaps) criteria, P1NP (N-terminal propeptide of procollagen type I) concentration and deoxypyridinoline (DPD) level. Results. 39.4% of patients older 60 years with low back pain on MRI demonstrated changes in sacroiliac joints with statistically significant higher (p = 0.037) pain level as compared to patients without pathology of sacroiliac joint, as well as higher values of TGF-beta 1 (p = 0.033), IL-1 beta (p = 0.028), IL-6 (p = 0.041), beta-CrossLaps (p = 0.028), P1NP (p = 0.037) and DPD (p = 0.002). Conclusion. Reported alterations in sacroiliac joint conditioned by degenerative and dystrophic processes are associated with distinctive signs of osteoarthrosis and confirm non-specific inflammation active with bone resorption in patients with low back pain.