Spontaneous Symptomatic Pseudoarthrosis at the T11–T12 Intervertebral Space With Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

Miyamoto, Kei; Shimizu, Katsuji; Arimoto, Rieko; Sakaguchi, Yasumichi; Nishimoto, Hirofumi; Kodama, Hirotaka; Hosoe, Hideo

doi:10.1097/01.brs.0000083321.62608.ee

Cited by 12 publications

(10 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Even in patients with psoriasis and IBD, spondylitis as well as DISH occur despite the fact that ankylosis starts in the cervicothoracic region, but pseudarthrosis in the majority of the reported cases has been located in the thoracolumbar region. 8,27,30,41,45,64 Generally, the clinical picture of ochronosis with regard to the vertebral column is consistent with the pathology retrospectively manifested with back pain and progressive restriction of the spinal movements. 4,5,19,34,38,40,59 In rare instances, the disc affected by deposition of the pigments becomes degenerated and might protrude or extrude posteriorly, with a clinical picture of disc herniation.…”

Section: Discussionsupporting

confidence: 58%

“…Since then, only a few cases of pseudarthrosis due to these 2 diseases have been published so far. 8,41,45,61 However, to the best of our knowledge, not a single case of pseudarthrosis as a sequela of ochronosis has been published previously. 69…”

Section: Incidencementioning

confidence: 96%

“…Although the estimated prevalence of this complication in AS ranges from 1% to 16%, 2,7,18,22,36,56 its occurrence in DISH, psoriasis, and IBD seems to be extremely low. 8,27,30,41,45,60,64 Pseudarthrosis in DISH was first reported by Quagliano et al in 1994; they reported 2 cases of spontaneous pseudarthrosis with DISH in the thoracolumbar region, and since then only 4 more cases have been published so far. 27,30,45,61 Pseudarthrosis in patients with psoriasis was first reported by Schilling et al in 1990, and it was reported in patients with IBD by Calin and Robertson in 1991.…”

Section: Incidencementioning

confidence: 97%

“…8,27,30,41,45,60,64 Pseudarthrosis in DISH was first reported by Quagliano et al in 1994; they reported 2 cases of spontaneous pseudarthrosis with DISH in the thoracolumbar region, and since then only 4 more cases have been published so far. 27,30,45,61 Pseudarthrosis in patients with psoriasis was first reported by Schilling et al in 1990, and it was reported in patients with IBD by Calin and Robertson in 1991. Since then, only a few cases of pseudarthrosis due to these 2 diseases have been published so far.…”

Section: Incidencementioning

confidence: 97%

See 3 more Smart Citations

Symptomatic pseudarthrosis in ochronotic spine: case report

Rahimizadeh

Soufiani

Hassani

2017

SPI

View full text Add to dashboard Cite

In this study the authors report the first example of spinal pseudarthrosis in a patient with ochronosis, and they describe the application of posterior-only 360° surgery as an alternative approach to combined anterior-posterior surgery in the management of pseudarthrosis of an ankylosed spine, regardless of its etiology. Spinal involvement in ochronosis produces loss of flexibility and ankylosis of thoracic and lumbar segments. Pseudarthrosis is a serious complication of the diseases that present with ankylosis of the spine. However, its occurrence in ochronotic spine has not been reported previously. Evaluation of progressive paraparesis in a 68-year-old man with ochronosis revealed pseudarthrosis at the T11–12 level. Circumferential dural sac decompression, debridement of the disc space, interbody fusion, and screw-rod fixation were all done via a posterior-only approach. Postoperatively the patient exhibited a marked recovery in terms of pain and neurological status. At the 3-month follow-up, he was able to walk independently. Ochronosis should be included in the etiology of pseudarthrosis. With aggravation of back pain and the appearance of neurological deficits in an already stable patient with any ankylosing disease, pseudarthrosis should be suspected. Furthermore, single-stage, 360°, posterior-only surgery may obviate the need for single-stage or staged anterior-posterior surgical intervention in patients with pseudarthrosis of the thoracic and lumbar spine.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Incidencementioning

confidence: 96%

Section: Incidencementioning

confidence: 97%

Section: Incidencementioning

confidence: 97%

See 2 more Smart Citations

Symptomatic pseudarthrosis in ochronotic spine: case report

Rahimizadeh

Soufiani

Hassani

2017

SPI

View full text Add to dashboard Cite

show abstract

“…Thereafter, kyphosis progressed gradually. We speculate that the reason for pedicle screw loosening and kyphosis deterioration in this patient may be related to mechanical stress of the long lever arm of the ankylosed spinal segments concentrated at the PTIF level and short segment fixation could not maintain the stability [6,21]. Therefore, if DISH is recognized in patients with TDH, a wider area of instrumentation including ankylosed spinal segments should be recommended in association with PTIF.…”

Section: Discussionmentioning

confidence: 89%

Surgical outcomes of posterior thoracic interbody fusion for thoracic disc herniations

et al. 2013

View full text Add to dashboard Cite

show abstract

Prompt surgical management for spinal fracture in the elderly aged over 90 years with diffuse idiopathic skeletal hyperostosis to extend their healthy lifespan

Tanishima

Takeda

Hamamoto

et al. 2012

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

There is a possibility that the patients with diffuse idiopathic skeletal hyperostosis (DISH) increase with aging of the population and progressive lengthening of life expectancy in developed countries. In the patients with DISH, even a trivial vertebral fracture may actually turn out to be a three-column injury because mechanical stress is applied to the fracture site due to the lever arm effect. Under these circumstances, even a prolonged strict immobilization often results in failure. Recently, elderly people increasingly wish to maintain physical abilities. We present three patients aged over 90 years with DISH sustaining lower thoracic vertebral fracture after minor trauma. Long fusion involving three vertebral levels above and below the fracture site was performed with pedicle screw system, and vertebroplasty was carried out by transpedicular filling with hydroxyapatite blocks. The patients' activities of daily living were maintained close to the pre-injury level 1 year and 9 months, 2 years and 3 months, and 1 year after surgery, respectively. Many reports have recommended surgery over conservative treatments at vertebral fracture complicating DISH; however, there has been no report of vertebral fracture in patients aged over 90 years with DISH. Satisfactory results were obtained by surgical treatment in our three patients despite their age. We recommend posterior fusion with vertebroplasty just after injury for vertebral fracture in the elderly patients of advanced age with DISH to extend their healthy lifespan.

show abstract

Spontaneous Symptomatic Pseudoarthrosis at the T11–T12 Intervertebral Space With Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

Abstract: A rare case of spontaneous symptomatic pseudoarthrosis at the T11-T12 intervertebral space with diffuse idiopathic skeletal hyperostosis was treated successfully by spinal fusion.

Cited by 12 publications

References 17 publications

Symptomatic pseudarthrosis in ochronotic spine: case report

Symptomatic pseudarthrosis in ochronotic spine: case report

Surgical outcomes of posterior thoracic interbody fusion for thoracic disc herniations

Prompt surgical management for spinal fracture in the elderly aged over 90 years with diffuse idiopathic skeletal hyperostosis to extend their healthy lifespan

Contact Info

Product

Resources

About