Computed Tomographic Evaluation of Degenerative Spine Changes in Patients with Obstructive Sleep Apnea Syndrome: A Case Control Study

Objective: Recently few studies have described presence of cervical spine anomalies in obstructive sleep apnoea syndrome (OSAS) patients. It is also reported that some cases of cervical spine pathologies and osteophytes producing obstructive sleep apnea. We aim to investigate the prevalence of facet joint arthrosis and degenerative disc disease (DDD) in cervical spine using computed tomography (CT) in OSAS patients. Materials and Methods: We studied on thirty patients with OSAS who had cervical spine CT. Facet joints were evaluated in four grades and scored in 1-4 points by using multiplanar CT images. Disc levels was evaluated by using two-point subjective scale for loss of height, posterior osteophytes, endplate sclerosis, and spinal canal stenosis to determinate DDD. Degeneration of anterior atlanto-odontoid joint (AAOJ) were classified into four grades. Tomographic findings were compared with those for thirty control subjects. Results: The mean degeneration scores of C2-T1 facet joints and C2-C5, C7-T1 disc spaces were significantly higher in the cases of OSAS group than the cases of the control group. There were no significant differences in the mean degeneration scores for C5-6 and C6-7 cervical intervertebral disc levels between the groups. Degeneration scores of the facet and disc for whole cervical spine in the cases of the OSAS group was significantly higher than in cases of the control group (P<0.001 and P=0.002). AAOJ degeneration degrees showed differences between the groups. Statistically significant correlations were found between the OSAS degrees and the intervertebral disc degeneration (R=0.338, P=0.007) and facet joint degeneration (R=0.543, P=0.000) for all cervical vertebrae. Conclusions: The cervical spine of the OSAS patients has more severe disc degeneration and facet joint and AAOJ arthrosis, compared to subjects without OSAS. This findings may contribute to clinic evaluation of OSAS patients with servical pain and limited movement.