1/10. Simultaneous cervical diffuse idiopathic skeletal hyperostosis and ossification of the posterior longitudinal ligament resulting in dysphagia or myelopathy in two geriatric North Americans.BACKGROUND: Cervical diffuse idiopathic skeletal hyperostosis (DISH) and ossification of the posterior longitudinal ligament (OPLL) rarely coexist in the North American population. Here, different surgical strategies were used to manage simultaneous DISH and OPLL resulting in dysphagia or myelopathy in two geriatric patients. methods: A 74-year-old male with esophageal compression and dysphagia attributed to DISH, and cord compression with myelopathy due to OPLL, was treated with a cervical laminectomy followed by anterior DISH resection. On the other hand, an 80-year-old male with asymptomatic DISH but moderate myelopathy (Nurick Grade III) secondary to OPLL required only a cervical laminectomy. RESULTS: In the first patient, dysphagia resolved within 3 months of surgery, while in the second individual, myelopathy improved to Nurick Grade I (mild myelopathy) within 6 months postoperatively. Improvement in both patients was maintained 1 year after surgery. CONCLUSIONS: While DISH and OPLL may coexist in geriatric patients, only those with dysphagia should undergo DISH resection, while others demonstrating myelopathy should have laminectomy alone.- - - - - - - - - - ranking = 1keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
2/10. Atlantoaxial subluxation associated with ossification of posterior longitudinal ligament of the cervical spine.STUDY DESIGN: Two case reports. OBJECTIVE: To demonstrate two rare cases of atlantoaxial subluxation associated with ossification of the posterior longitudinal ligament of the cervical spine, in which spastic quadriplegia developed. SUMMARY OF BACKGROUND DATA: There are only two reports of an association of diffuse idiopathic skeletal hyperostosis with atlantoaxial subluxation. This condition often accompanies ossification of the posterior longitudinal ligament of the cervical spine, but there is nothing in the literature about the association of ossification of the posterior longitudinal ligament with atlantoaxial subluxation. methods: Clinical and radiographic findings of these two cases were demonstrated. In both cases laminoplasty of the cervical spine was performed with occipitoaxial arthrodesis. RESULTS: The spastic quadriplegia of these two patients caused by myelocompression improved after surgical intervention. CONCLUSION: Ossification of the posterior longitudinal ligament of the cervical spine may cause atlantoaxial subluxation.- - - - - - - - - - ranking = 0.2keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
3/10. Ossification of the posterior longitudinal ligament in vitamin d-resistant rickets: case report and review of the literature.STUDY DESIGN: A case report of cervical myelopathy caused by ossification of the posterior longitudinal ligament in a patient with vitamin d-resistant rickets is presented together with a review of literature. OBJECTIVE: To report the diagnosis of ossification of the posterior longitudinal ligament in a white woman with vitamin d-resistant rickets. SUMMARY OF BACKGROUND DATA: The association between ossification of the posterior longitudinal ligament and untreated vitamin d-resistant rickets has been reported in japan, but infrequently in white populations. In whites, ossification of the posterior longitudinal ligament is closely associated with diffuse idiopathic skeletal hyperostosis. A clear association between ossification of the posterior longitudinal ligament and vitamin d-resistant rickets in white populations has not yet been established. methods: The medical record and imaging studies of a patient treated at the authors' institution for cervical myelopathy caused by ossification of the posterior longitudinal ligament in the setting of treated vitamin d-resistant rickets were reviewed. A medline search of the medical literature between 1966-1999 was performed to identify pertinent studies and similar case reports. RESULTS: The occurrence of spinal stenosis in untreated adults with vitamin d-resistant rickets has been reported in all regions of the spine in Japanese patients. The association between ossification of the posterior longitudinal ligament and untreated vitamin d-resistant rickets was first reported in japan, where ossification of the posterior longitudinal ligament is endemic. This association may be incidental, because reports on ossification of the posterior longitudinal ligament in whites are not as frequent as in Japanese, reflecting the higher prevalence of this condition in japan. CONCLUSION: Ossification of the posterior longitudinal ligament and ossification of the posterior longitudinal ligament associated with deranged calcium or phosphate metabolism may be different pathologic entities sharing a common outcome. Adequate treatment of vitamin d-resistant rickets may not always prevent or reverse ossification of the posterior longitudinal ligament.- - - - - - - - - - ranking = 0.2keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
4/10. Clinics in diagnostic imaging (55). Ossification of the posterior longitudinal ligament.Ossification of the posterior longitudinal ligament (OPLL) of the cervical spine associated with diffuse idiopathic skeletal hyperostosis is described in a 70-year-old Caucasian man presenting with a rapidly progressive myelopathy. The acute nature of his myelopathic symptoms and cervical canal stenosis necessitated posterior decompressive surgery. Four other patients with OPLL are presented to illustrate the spectrum of imaging findings. The computed tomographic features of OPLL are distinctive.A 2-5 mm thick linear ossified strip along the posterior vertebral margin usually at mid cervical (C3 to C5) level characterises the condition. Magnetic resonance (MR) imaging is valuable in excluding possible cord damage and associated disc lesions prior to surgery. A calcified central sequestrated disc is the only condition that may be mistaken for the segmental and retrodiscal forms of OPLL In a clinical setting of compressive myelopathy, it is pertinent to distinguish between these two conditions since a sequestrated disc has a more favourable surgical prognosis. The merits and relevance of anterior and posterior surgery together with their possible complications are outlined.- - - - - - - - - - ranking = 0.2keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
5/10. Cervical cord injury in an elderly man with a fused spine--a case report.We report a case of an elderly man presenting with co-existing diffuse idiopathic skeletal hyperostosis (DISH) and ossified posterior longitudinal ligament (OPLL) resulting in central cord syndrome. Only three such cases have been reported co-existing with DISH. The patient recovered most of his neurological deficit through conservative management. A discussion on the radiological features of DISH co-existing with OPLL and how these differ from ankylosing spondylitis (AS) follows.- - - - - - - - - - ranking = 0.2keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
6/10. quadriplegia complicating ossification of the posterior longitudinal ligament.We report a case of quadriplegia complicating ossification of posterior longitudinal ligament (OPLL) in a patient who was also found to have diffuse idiopathic skeletal hyperostosis (DISH). She also had osteomalacia (Vit. D deficiency) with secondary hyperparathyroidism. There could be a cause and effect relationship between the abnormal biochemistry and OPLL.- - - - - - - - - - ranking = 0.2keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
7/10. Ossification of the posterior longitudinal ligament of the cervical spine and SAPHO syndrome.We describe a case of cervical cord compression due to ossification of the posterior longitudinal ligament of the spine (OPLLS) in a 43-year-old Vietnamese patient with SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis). Idiopathic OPLLS is mainly reported in 50- to 60-year-old men, particularly in Japanese, with a prevalence of 2%. Cervical myelopathy may occur. In addition to OPLLS in patients of Asian origin, the condition has also been described in association with ossifying diseases, including ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) but not previously, to our knowledge, with SAPHO syndrome.- - - - - - - - - - ranking = 0.20342221662899keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
8/10. Ossification of the posterior longitudinal ligament, diffuse, idiopathic skeletal hyperostosis, abnormal retinol and retinol binding protein: a familial observation.We describe a 52-year-old man who presented with diffuse idiopathic skeletal hyperostosis, ossification of the posterior longitudinal ligament, and abnormal levels of retinol and retinol binding protein (RBP). The molar retinol/retinol binding protein ratio was high, suggesting congenital functional RBP deficiency. His two sons, aged 23 and 27 years, shared the same biological abnormality without clinical symptoms. To our knowledge, this is the first case report of such a familial association.- - - - - - - - - - ranking = 0.54088502394099keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
9/10. A rare neurological presentation due to ossification of the posterior longitudinal ligament of the thoracic spine and ankylosing spondylitis: case report.Ossification of the posterior longitudinal ligament (OPLL) may be associated with certain rheumatic conditions including ankylosing spondylitis (AS), diffuse idiopathic skeletal hyperostosis (DISH) or spondylosis. More than 95% of all OPLL are localized at the cervical spine. Herein, we report a case of OPLL at the thoracic spine in an HLA-B27-positive female patient with ankylosing spondylitis. The patient was presented to use with spastic paraparesis. The imaging studies included plain roentgenograms, tomograms, myelo-CT and magnetic resonance imaging (MRI). A continuous rod-like ossification along the posterior aspects of the fourth to sixth thoracic vertebrae with spinal cord compression was noted. The patient underwent a laminectomy from T4 to T6. At the second year follow-up examination, residual upper back soreness and mild left thigh pain were noted. However, the patient had resumed a full daily schedule and could walk freely without any support.- - - - - - - - - - ranking = 0.2keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
10/10. Ossification of the posterior longitudinal ligament in Down's syndrome.Cervical myelopathy in patients with Down's syndrome is not uncommonly the result of atlanto-axial instability, a condition that is caused by ligamentous laxity and which may be associated with congenital osseous anomalies at the occipito-atlanto-axial axis. Ossification of the posterior longitudinal ligament (OPLL) is well described, particularly in the Japanese population, and may be associated with diffuse idiopathic skeletal hyperostosis. This is the first case, to our knowledge, of OPLL occurring in a person with Down's syndrome presenting with myelopathy.- - - - - - - - - - ranking = 0.2keywords = diffuse idiopathic skeletal hyperostosis, idiopathic skeletal hyperostosis, diffuse idiopathic, skeletal hyperostosis, hyperostosis, idiopathic (Clic here for more details about this article) |
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