Cervical myelopathy caused by ossification of the posterior longitudinal ligament in ankylosing spondylitis

Olivieri, Ignazio; Fiandra, Elisabetta; Muscat, Christopher; Barozzi, Libero; Tomassini, C; Gerli, Roberto

doi:10.1002/art.1780391219

Cited by 9 publications

(7 citation statements)

References 14 publications

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“…Although ossifi cation of the posterior longitudinal ligament has been described in AS [24][25][26][27], it is much more frequent in DISH [23]. Apophyseal joint alteration-involving partial or complete ankylosis of the zygapophyseal, costovertebral, and costotransverse joints-is typically present in advanced AS, whereas only some narrowing with hypertrophic alterations and capsular ossifi cation can be observed in these joints in DISH.…”

Section: Ankylosing Spondylitismentioning

confidence: 99%

“…DISH may also be associated with ossifi cation of the posterior longitudinal ligament, especially of the cervical spine, which can further aggravate the spinal canal stenosis [23]. Some degree of ossifi cation of the syndesmoses of the vertebral arches and of the posterior longitudinal ligament can occasionally also be observed in patients with AS without any signs of DISH [24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diffuse idiopathic skeletal hyperostosis: Differentiation from ankylosing spondylitis

Olivieri

D’Angelo²,

Palazzi³

et al. 2009

Curr Rheumatol Rep

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133

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Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS) share involvement of the axial skeleton and peripheral entheses. Both diseases produce bone proliferations in the later phases of their course. Although the aspect of these bone proliferations is dissimilar, confusion of radiologic differential diagnosis between the two diseases exists mostly as a consequence of a lack of awareness of their characteristic clinical and radiographic features. The confusion may extend to the clinical field because both advanced DISH and advanced AS may cause the same limitations of spinal mobility and postural abnormalities. However, the radiologic spinal findings are so different that changes due to each disease can be recognized even in patients in whom both diseases occur. This article reviews the clinical and radiologic characteristics that should help clinicians differentiate between the two diseases without much difficulty.

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Section: Ankylosing Spondylitismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diffuse idiopathic skeletal hyperostosis: Differentiation from ankylosing spondylitis

Olivieri

D’Angelo²,

Palazzi³

et al. 2009

Curr Rheumatol Rep

Self Cite

133

View full text Add to dashboard Cite

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“…Há associação com espondilite anquilosante e hiperostose esquelética difusa idiopática em até 40 a 50% dos casos 5,10,11 . Pacientes com OLLP apresentam incidência aumentada de obesidade, intolerância à glicose e diabete melito do tipo II.…”

Section: Discussionunclassified

Ossificação do ligamento longitudinal posterior na coluna cervical: relato de caso

Scola

Werneck

Iwamoto

et al. 1998

Arq. Neuro-Psiquiatr.

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RESUMO -A ossificação do ligamento longitudinal posterior (OLLP) é causa incomum de mielopatia compressiva na população caucasiana. É relatado o caso de um paciente do sexo masculino com um quadro de paraparesia espástica, cuja investigação radiológica mostrou OLLP. O raio-X de coluna cervical mostrou imagem laminar, vertical, com densidade óssea, posterior aos corpos vertebrais, que se estendia de C2 a T1. A tomografia computadorizada (TC) e a mielotomografia mostravam OLLP causando compressão medular ântero-posterior no segmento descrito. Na ressonância magnética, observou-se área de hiperintensidade em T2 no segmento C7-T1, compatível com mielomalácia. O paciente foi submetido a laminoplastia tipo "open-door", com melhora do quadro parético dos membros inferiores. A OLLP deve entrar no diagnóstico diferencial das mielopatias cervicais, sendo facilmente diagnosticada através de radiografias e TC da coluna cervical. São revisados os aspectos clínicos e radiológicos e o tratamento da OLLP. PALAVRAS-CHAVE: ossificação do ligamento longitudinal posterior, mielopatia cervical, tomografia computadorizada, ressonância magnética.Ossification of the posterior longitudinal ligament in the cervical spine: case report ABSTRACT -Ossification of the posterior longitudinal ligament (OPLL) is an uncommon cause of compressive myelopathy in the Caucasian population. A case of spastic paraparesis in a Caucasian man whose radiological investigation showed OPLL is presented. The radiographs of the cervical spine showed a strip of bony density posterior to the vertebral bodies, extending from C2 to T1. Computerized tomography (CT) and CT myelography showed OPLL at the same level. Magnetic resonance showed an area of increased signal on T2-weighted sequences at C7-T1 level suggestive of myelomalacia. The patient underwent an open-door laminoplasty (C2 to C7) with improvement of the paraparesis. OPLL should be included in the differential diagnosis of cervical myelopathy. It can be easily detected by plain radiographs and CT of the cervical spine. A review of the clinical and radiological features and the treatment of OPLL is presented.KEY WORDS: ossification of the posterior longitudinal ligament, cervical myelopathy, computerized tomography, magnetic resonance.A ossificação do ligamento longitudinal posterior (OLLP) é causa frequente e bem estudada de mielopatia cervical no Japão 1,2 . A maior série de OLLP existente na literatura foi publicada pelo Ministério da Saúde do Japão, com 2125 casos 1,3 e estima-se que mais de 3% da população japonesa

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“…44 Although neurologic sequelae of AS are uncommon, neurological changes can result from fractures, pseudarthroses, atlantoaxial subluxation, ossification of the posterior longitudinal ligament, and the cauda equina syndrome (CES) associated with AS. [45][46][47][48] The appearances of some of these characteristic findings on MR images have been described in the literature.…”

Section: Mri Of the Spine In Asmentioning

confidence: 99%

MR Imaging of Ankylosing Spondylitis

2003

Semin Musculoskelet Radiol

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Ankylosing spondylitis (AS) is one of a group of disorders characterized by association with HLA-B27 histocompatibility complex, seronegativity for rheumatoid factor, and propensity for inflammation at entheses, synovial articulations, and cartilaginous articulations. The radiographic hallmark of the disease is ankylosis, and the principle sites of involvement are the sacroiliac joints and spine, with less frequent involvement of other joints, including the pubic symphysis, hips, shoulders, knees, hands, feet, and sternoclavicular, acromioclavicular, sternomanubrial, and temporomandibular joints. Following a brief discussion of the basic pathophysiology and typical clinical findings of AS, we describe the typical magnetic resonance imaging features of the disease as it is manifests in the axial skeleton. Finally, a brief mention of special considerations in the radiographic evaluation of the AS patient in the setting of trauma is made.

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Cervical myelopathy caused by ossification of the posterior longitudinal ligament in ankylosing spondylitis

Cited by 9 publications

References 14 publications

Diffuse idiopathic skeletal hyperostosis: Differentiation from ankylosing spondylitis

Diffuse idiopathic skeletal hyperostosis: Differentiation from ankylosing spondylitis

Ossificação do ligamento longitudinal posterior na coluna cervical: relato de caso

MR Imaging of Ankylosing Spondylitis

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