Amyloid Destructive Spondyloarthropathy Causing Cord Compression

Davidson, George S.; Montanera, Walter; Fleming, Janine; Gentili, Fred

doi:10.1097/00006123-199309000-00026

Cited by 5 publications

(6 citation statements)

References 22 publications

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“…15 Such amyloid deposits in the vertebral body and disk lead to damage and loss of structural integrity and to further erosive destruction of the spinal segment. 3 Ito et al 5 (delete this word) We previously reported a distribution pattern of amyloid deposition in the facet joints, intervertebral discs, and vertebral bodies. 5 Amyloid was densely deposited at the enthesis of collagen fibers to the bone at the facet joints and in the peripheral tears of the annulus fibrosis (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

“…The subaxial cervical spine was the most frequently involved region. 1,3,11,15 β2-microglobulin amyloidosis is one major cause of DSA and the middle cervical discs are the most susceptible to this β2-microglobulin amyloid deposition. 15 Risk factors for the development of DSA include the duration of renal failure, duration of hemodialysis, and various clinical variable factors.…”

Section: Cervical Disorders In Hemodialysis Patientsmentioning

confidence: 99%

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Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis

Sudo

Ito

Abumi

et al. 2006

SPI

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Object As increasing numbers of patients receive long-term hemodialysis, the number of reports regarding hemodialysis-related cervical spine disorders has also increased. However, there have been few reports summarizing the surgical results in patients with these disorders. The objective of this study was to evaluate the long-term follow up and clinical results after surgical treatment of cervical disorders in patients undergoing hemodialysis. Methods Seventeen patients in whom surgery was performed for cervical spine disorders while they received long-term hemodialysis therapy were enrolled in this study. Of these, 15 underwent follow-up review for more than 3 years after surgery, and these represent the study population. The remaining two patients died of postoperative sepsis. The average follow-up period was 120 months. Five patients without spinal instability underwent spinal cord decompression in which bilateral open-door laminoplasty was performed. Ten patients with destructive spondyloarthropathy (DSA) underwent reconstructive surgery involving pedicle screw (PS) fixation. In eight patients in whom posterior instrumentation was placed, anterior strut bone grafting was performed with autologous iliac bone to treat anterior-column destruction. Marked neurological recovery was obtained in all patients after the initial surgery. In the mobile segments adjacent to the site of previous spinal fusion, the authors observed progressive destructive changes with significant instability in four patients (40%) who underwent circumferential spinal fusion. No patients required a second surgery after laminoplasty for spinal canal stenosis without DSA changes. Conclusions Cervical PS-assisted reconstruction provided an excellent fusion rate and good spinal alignment. During the long-term follow-up period, however, some cases required extension of the spinal fusion due to the destructive changes in the adjacent vertebral levels. Guidelines or recommendations to overcome these problems should be produced to further increase the survival rates of patients undergoing hemodialysis.

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Section: Discussionmentioning

confidence: 99%

Section: Cervical Disorders In Hemodialysis Patientsmentioning

confidence: 99%

Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis

Sudo

Ito

Abumi

et al. 2006

SPI

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“…Carpal tunnel syndrome is often associated in such patients. 30 Sometimes, localized deposits of amyloid appear as densely calcified lesions on CT and plain films ( Figs 6A, -B and 7A, -B). They commonly extend into the soft tissues.…”

Section: Spinal Involvementmentioning

confidence: 99%

“…Clinically, the patients can present with myelopathy symptoms or radiculopathy. 30 Imaging features are nonspecific; other entities producing diffuse leptomeningeal enhancement like infection, neoplasm (primary or secondary), and inflammatory entities like sarcoidosis need to be excluded. When diffuse leptomeningeal enhancement (Fig 8A, -B) is associated with hypertrophy of the ligaments within the spinal canal and thickening of the nerve roots, one should consider amyloidosis related to FAP in the differential diagnosis.…”

Section: Meningeal Depositsmentioning

confidence: 99%

Imaging of Focal Amyloid Depositions in the Head, Neck, and Spine: Amyloidoma

Parmar¹,

Rath²,

Castillo³

et al. 2010

AJNR Am J Neuroradiol

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SUMMARY:Amyloidomas are benign tumorlike lesions consisting of localized deposits of amyloid and are the rarest form in the group of amyloidosis-related lesions. Diagnosis requires special stains; therefore, a high degree of suspicion for this disease is required. In this review, we describe the imaging features of amyloidomas involving the intracranial compartment, head and neck, and spine. We also discuss the differential diagnosis and briefly review the pertinent literature.ABBREVIATIONS: FAP ϭ familial amyloidotic polyneuropathy; T1WI ϭ T1-weighted images; T2WI ϭ T2-weighted images

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“…Because the clinical presentation was mostly caused by a mass effect to the spinal root or spinal cord [3,4,7,[14][15][16], medical therapy is limited to symptomatic approaches to lessen pain and inflammation in joints [3]. Therefore, prompt evaluation of long-term hemodialysis patients suffering from cervical pain should be emphasized so that they can be referred for surgical evaluation.…”

Section: Discussionmentioning

confidence: 99%

Hemodialysis-related upper cervical extradural amyloidoma presenting with intractable radiculopathy

et al. 2011

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Introduction Destructive spondyloarthropathy may occur in long-term hemodialysis patients, but focal amyloid deposits in the spine are rare. We present a case of upper cervical extradural amyloidoma with a history of long-term hemodialysis presenting with progressive and intractable radiculopathy. Clinical presentation We describe a 51-year-old female with a long-term history of hemodialysis treatment. She suffered progressive and intolerable right occipital headache. Neurological examination revealed right C2 radiculopathy. Magnetic resonance imaging (MRI) of the cervical spine showed a solid focal extradural mass lesion at the C2 level. She underwent subtotal resection of the extradural mass lesion and decompression of the right C2 nerve root by a posterior approach. Histological examination revealed amyloid deposits. The occipital headache immediately disappeared after surgery. Follow-up MRI 10 months after surgery demonstrated no recurrence of the extradural amyloidoma. Conclusion Development of an upper cervical extradural amyloidoma after long-term hemodialysis is extremely rare. Prompt evaluation of long-term hemodialysis patients suffering from progressive cervical pain should be recommended, and treatment is required if there are signs or symptoms of compression of a nerve root or the spinal cord.

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Amyloid Destructive Spondyloarthropathy Causing Cord Compression

Cited by 5 publications

References 22 publications

Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis

Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis

Imaging of Focal Amyloid Depositions in the Head, Neck, and Spine: Amyloidoma

Hemodialysis-related upper cervical extradural amyloidoma presenting with intractable radiculopathy

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