Getting down & Medical

Osteoproliferation despite inflammation

Osteoproliferation is the formation of new bone outside a bone's normal borders. In AS, new bone grows on the outer surface of the cortical bone (dense external part of bones) in the spine, leading to reduced joint mobility. Meanwhile, the trabecular bone (spongy bone) is degraded in the central parts of vertebral bodies, making the vertebrae more susceptible to fractures.

Why is it that some AS patients develop bone formation along the spine over a lifetime and some do not? Is there a genetic predisposition that accentuates this process and is it detectable? I’ve recently read a clinical study by Eva Klingberg from the Center for Bone and Arthritis Research at the University of Gothenburg in Sweden. Her cross-sectionsal study was conducted on 210 AS patients and compared lifestyle, biomarkers, bone microarchitecture and bone macroscopic changes between these AS patients and healthy controls. Klingberg's findings suggests that there are certain genetic biomarkers seen in AS related osteoproliferation, meaning that specific genetic test could be used to identify this predisposition. This may seem like a revelation, but it does not change how we should establish preventive measures.

Allopathic medecine puts much effort into lowering inflammation. As a patient, this at first made me presume that inflammation was the primary culprit in bone formation along the spine. However, abnormal bone spurs can still develop in spite of inflammation control (Eva Klingberg, 2013). However, inflammation and pain are often completely resolved once segmental fusion has taken place. Could this mean that inflammation's role in osteoproliferation is secondary? Chronic inflammation in itself is unhealthy to human tissue, causing irreversable damage to the ligaments and tissues around the spine. That may be why some feel more or less pain depending on the compression or irritation of nerves along the spine and the mobility of the surrounding ligaments. This pain and stiffness discourages movement in any plane of motion leaving you stiff as a board. This is where you do not want to find yourself. Medication's role in inflammatory control allows you to exercise and enhances your quality of life. We all know that there is no cure yet for AS, but many sufferers are playing all of their cards on the hope that medication will make it all better. The truth of the matter is you are not sheltered from bone formation even if inflammation is controlled. You need to take advantage of the freedom of movement that medication is providing you with and not allow space in your joints to disappear.

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