The purpose of this study is to compare incidence of degenerative scoliosis (DS) in patients who diagnosed lumbar spinal stenosis (LSS) with or without rheumatoid arthritis (RA) and identify the risk factors of DS severity in RA patients. 61 LSS patients with RA (RA group) and 87 demographic-matched LSS patients without RA (NoRA group) from January 2013 to April 2018 were enrolled. The extracted information includes RA-related parameters such as Steinbrocker classification, disease-modifying anti-rheumatic drugs (DMARDs), and DS-related information such as Cobb angle, apical vertebra, along with osteoporosis and history of total knee arthroplasty (TKA). Comparisons between RA and NoRA group and between DS and non-DS subgroup with RA were performed, as well as the risk factors on DS severity in RA patients. The incidence of DS in RA group was 42.6%, larger than that of NoRA group (P = 0.002). The mean Cobb angle between the two groups was of no difference (P = 0.076). The apical vertebrae were both mainly focused on L3 and L4 vertebrae in both groups with no significant difference on the distribution of apical vertebrae (P = 0.786). Female took a larger proportion in DS subgroup than that of NoDS subgroup in patients with RA (P = 0.039), while Steinbrocker classification was irrelevant to the occurrence of DS and Cobb angle. Multiple regression analysis showed that TKA was a risk factor for the severity of Cobb angle (P = 0.040). The incidence of DS in LSS patients with RA is higher than non-RA patients. RA patients performed TKA sustained less severity of DS.

中文翻译：

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类风湿性关节炎患者退行性脊柱侧凸合并腰椎管狭窄的风险预测：病例对照研究。

本研究的目的是比较诊断为腰椎管狭窄 (LSS) 伴或不伴类风湿性关节炎 (RA) 的患者中退行性脊柱侧凸 (DS) 的发生率，并确定 RA 患者中 DS 严重程度的危险因素。2013年1月至2018年4月，纳入61例患有RA的LSS患者（RA组）和87例人口统计学匹配的无RA的LSS患者（NoRA组）。提取的信息包括 RA 相关参数，如 Steinbrocker 分类、缓解病情抗风湿药物 (DMARD) 和 DS 相关信息，如 Cobb 角、顶椎，以及骨质疏松症和全膝关节置换术 (TKA) 病史。比较RA与NoRA组、DS与非DS亚组的RA，以及RA患者DS严重程度的危险因素。RA组DS发生率为42.6%，高于NoRA组（P=0.002）。两组之间的平均Cobb角没有差异（P = 0.076）。两组顶椎均主要集中于L3、L4椎骨，顶椎分布无显着性差异（P=0.786）。RA患者中DS亚组女性比例高于NoDS亚组（P=0.039），而Steinbrocker分型与DS和Cobb角的发生无关。多元回归分析显示TKA是Cobb角严重程度的危险因素（P = 0.040）。伴有 RA 的 LSS 患者 DS 发生率高于非 RA 患者。接受 TKA 的 RA 患者 DS 严重程度较低。