INTRODUCTION: 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: 443 participants from the Framingham Heart Study Multi‐Detector Computed Tomography (CT) 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 CT scans using a 4‐grade scale. For analytic purposes, FJ OA was dichotomized as moderate FJ OA of at least one joint 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, gender and BMI. Furthermore, we examined the effect of including the known cardiovascular risk factors of diabetes, hypertension, hypercholesterolemia, and smoking.
RESULTS: Low AAC (OR 3.9 [2.3‐6.5];p=<0.0001) and high AAC (OR 9.7 [5.2‐18.1];p=<0.0001) were strongly associated with FJ OA, compared with the reference group. After adjusting for age, gender, and BMI, the association with FJ OA was attenuated for both low AAC (OR 1.9 [1.1‐3.4];p=0.03) and high AAC (OR 2.2 [0.96‐5.1];p=0.06). The addition of cardiovascular risk factors to the model did not attenuate the relationship between low AAC (OR 2.0 [1.1‐3.6];p=0.03) or high AAC (OR 2.6 [1.1‐6.3];p=0.04) and FJ OA. BMI and age were also significant correlates with FJ OA in the final model.
CONCLUSIONS: Abdominal aortic calcifications are 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 degeneration unrelated to conventional biomechanical paradigms may exist. This study is limited by a cross‐sectional design; longitudinal studies are needed.