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Results for “OSSIFICATION”

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At least 37 records · Page 2Linked to original sources

PubMed2005

Surgery for dural ossification in association with cervical ossification of the posterior longitudinal ligament via an anterior approach.

STUDY DESIGN: Direct removal of an ossified mass via an anterior approach carries good decompression, to one- or two-level ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. Ossification occasionally involves not only the posterior longitudinal ligament (PLL) but also the underlying dura mater. Defect of the dura mater by resection of the dural ossification (DO) can cause cerebrospinal fluid leakage or neural injury. The technique of resection of OPLL with floating of DO provides satisfactory decompression and avoids dural defect or neural injury in OPLL associated with DO. METHODS: Four patients developed cervical myelopathy. Radiological examination revealed cord compression due to OPLL associated with DO. RESULTS: All patients underwent anterior procedures. After the necessary discectomies and corpectomies, OPLL was resected using a high-speed drill with a 4-mm steel burr and then with a 4-mm diamond burr. When the OPLL became paper-thin, it was separated from the dura mater using a microdissector and a Kerrison rongeur. There was a thin layer of the nonossified degenerated PLL between the residual OPLL and DO. Meticulous dissection of the residual OPLL over the DO was performed without removing the DO at this layer. Fixation was performed with a titanium cylindrical cage. CONCLUSION: This technical note describes the successful decompression of the spinal cord by removing OPLL only, and avoidance of dural defect or neural injury in cases of OPLL associated with DO.

Adult↗

PubMed2005

Dendriform pulmonary ossification, a form of diffuse pulmonary ossification: report of a 26-year autopsy experience.

CONTEXT: Dendriform pulmonary ossification (DPO) is an uncommon form of diffuse pulmonary ossification that typically affects the pulmonary interstitium in a setting of interstitial fibrosis. OBJECTIVE: To determine the incidence and characteristics of DPO and correlate the clinical, radiographic, and pathologic features in order to better understand its pathogenesis and behavior and facilitate proper therapy. DESIGN: Adult autopsies performed at a tertiary care center from 1978 to 2004 were reviewed to identify cases of DPO. Clinical, radiographic, and pathologic findings, including ultrastructural studies in select cases, were analyzed and correlated. RESULTS: Eight cases of DPO were identified from 1393 adult autopsies. None of the cases was diagnosed antemortem. The prevalence of DPO was 0.5%, and the incidence was 0.28 cases per year. Most patients had a history of chronic lung disease, and all were 65 years of age or older. CONCLUSIONS: Dendriform pulmonary ossification is an uncommon and unusual entity seen incidentally at autopsy and associated with chronic lung disease. It is well demonstrated in postmortem examination, confirmed by microscopy and ultrastructural study, but rarely diagnosed and virtually never considered clinically. Clinical diagnoses include bronchiectasis and interstitial pneumonitis based on radiographic evidence. With its associated radiographic/pathologic findings, DPO should be considered in the differential diagnosis of chronic lung disease.

Aged↗

PubMedDate not supplied

Merging the old skeletal biology with the new. I. Intramembranous ossification, endochondral ossification, ectopic bone, secondary cartilage, and pathologic considerations.

Skeletogenesis and chondrogenesis result from a sequence of events involving epithelial-mesenchymal interaction, condensation, and differentiation. Types of bone and cartilage formation include: (1) intramembranous ossification, (2) endochondral ossification, (3) combined endochondral and intramembranous ossification, (4) heterotopic bone and cartilage formation, and (5) secondary cartilage formation. Pathologic conditions with bone and cartilage include: (1) benign and malignant tumors and (2) reactive osseous and cartilaginous metaplasia.

Animals↗

PubMed2006

Transient paraparesis after laminectomy for thoracic ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum.

STUDY DESIGN: Case report. OBJECTIVES: To report a case with thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF), in which postoperative paralysis occurred after laminectomy and was reversed after an additional posterior instrumented fusion. SETTING: A University Hospital in Japan. CASE REPORT: A 71-year-old woman, with a spastic palsy of both lower extremities, had OPLL and OLF at T10-T11, which pinched the spinal cord anteriorly and posteriorly. She underwent a laminectomy at T10-T11, and no further neurological deterioration was seen immediately after surgery. Over the next 18 h, however, myelopathy worsened, showing severe paraparesis. An additional posterior instrumented fusion at T7-L1 was performed without correction of the kyphosis. After fusion, neurological deficits gradually recovered, despite the presence of residual anterior impingement of spinal cord by the OPLL. CONCLUSIONS: The present case provides evidence for the possibility that laminectomy alone produces postoperative paralysis for combined thoracic OPLL and OLF, and we recommend that a posterior instrumented fusion should be added when posterior decompression is performed for this disorder.

Female↗

PubMed2005

Computer-assisted measurement of the size of ossification in patients with ossification of the posterior longitudinal ligament in the cervical spine.

BACKGROUND: Progression of ossification of the posterior longitudinal ligament in patients may lead to serious neurological deterioration. A government-funded study group established a manual method of measurement on plain radiographs to detect progression of the ossified lesion. However, this method did not gain wide acceptance because it was time-consuming and complicated, for which drawings of many lines and points are required. We have applied a computer-assisted measurement system to this task and have evaluated inter- and intraexaminer reliability, showing that it is quicker to use and more accurate than the manual method. METHODS: Eight board-certified spine surgeons, acting as the examiners, measured the sizes of the ossified lesions on nine lateral cervical spine radiographs using the computer-assisted measurement system. Following insertion of digitized radiographic image data into a computer, the corners of the vertebral bodies on the displayed images are marked by the examiners, and the software automatically sets reference lines and points. The examiners identify upper, lower, and posterior margins of the ossified lesions, and the software calculates the dimensions of the ossified lesions. Data obtained from eight examiners for length and thickness underwent rigorous statistical analysis by calculating the intraclass correlation coefficients with 95% confidence intervals (CIs) to determine interexaminer reliability and Pearson's correlation coefficients between the two measurements by the same examiner to determine intraexaminer reliability. RESULTS: The intraclass correlation coefficients were 0.927 and 0.968 with 95% CIs of 0.883-0.955 and 0.956-0.978 for measurements of length and thickness, respectively, of the ossified lesions. The Pearson's correlation coefficients for the two measurements by the same examiners were 0.943-0.985 for length and 0.957-0.991 for thickness. CONCLUSIONS: The inter- and intraexaminer reliability using this measurement system was excellent. The method can detect progression of ossification of the posterior longitudinal ligament (OPLL) on plain radiographs with high precision and could become a standard method for measuring the size of OPLL.

Cervical Vertebrae↗

PubMed1999

Ossification of the yellow ligament and spondylosis and/or ossification of the posterior longitudinal ligament of the thoracic and lumbar spine.

Combinations of varying degrees of spondylosis and/or ossification of the posterior longitudinal ligament (OPLL), and ossification of the yellow ligament (OYL) contribute to thoracic and lumbar neural compression in North Americans. Preoperative magnetic resonance and computed tomography examinations dictated the surgical approaches used to address spondylosis/OPLL in 11 patients, OYL in 12 patients, and spondylosis/OPLL and OYL in 3 patients. Myelopathy (4 patients), radiculopathy (13 patients), and cauda equina dysfunction (11 patients) were observed, 2 patients showing combined deficits. Outcomes (Odom's criteria) after laminectomy (24 patients) and circumferential thoracic procedures (2 patients) were good to excellent in the 73% of patients with spondylosis/OPLL, in 83% with OYL, and excellent for all 3 with spondylosis/OPLL and OYL. Full recognition of thoracic or lumbar spondylosis/OPLL and OYL ensure optimal surgical planning and outcomes.

Adult↗

PubMed1999

Laminectomy with posterior wiring and fusion for cervical ossification of the posterior longitudinal ligament, spondylosis, ossification of the yellow ligament, stenosis, and instability: a study of 5 patients.

Cervical laminectomy with posterior wiring and fusion is valuable for the management of cervical ossification of the posterior longitudinal ligament (OPLL), spondylosis, ossification of the yellow ligament (OYL), stenosis, and instability. Within 1.5 years, five patients averaging 73 years of age developed severe myelopathy. Dynamic radiographs confirmed an intact cervical lordosis with active subluxation and instability at one or two levels, whereas magnetic resonance and computed tomography scans showed OPLL, spondylosis, OYL, and stenosis. After multilevel laminectomy with posterior wiring and fusion and immobilization in cervicothoracic orthoses, patients fused in an average of 3.6 months. All patients improved, showing mild to moderate residual postoperative myelopathy an average of 13 months later (range, 6-19 months). With an intact cervical lordosis, laminectomy with posterior wiring and fusion was used successfully to manage five patients with OPLL, spondylosis, OYL, stenosis, and instability.

Aged↗

PubMed2005

Surgical outcome of ossification of the posterior longitudinal ligament (OPLL) of the thoracic spine: implication of the type of ossification and surgical options.

OBJECTIVE: Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine produces myelopathy through anterior spinal cord compression that is usually progressive and unaffected by conservative treatment. Therefore, early decompressive surgery is imperative. However, decompression surgery of thoracic myelopathy is difficult, and the outcome is often poor. A retrospective study was conducted to investigate the surgical outcome of 21 patients with thoracic OPLL to evaluate which type of surgical approach is better and which type of thoracic OPLL results in a better surgical outcome. METHODS: A total of 21 patients with thoracic OPLL (10 men and 11 women; mean age 54 years), who underwent surgical treatment at our department from March 1985 to October 2000, were included in the study. Seven patients exhibited the flat-type OPLL and underwent either anterior decompression and fusion (one patient), anterior decompression via a posterior approach (three patients), or expansive laminoplasty (three patients). Fourteen patients exhibited the beak-type OPLL and also underwent either anterior decompression and fusion (two patients), anterior decompression via a posterior approach (six patients), or expansive laminoplasty (six patients). RESULTS: Regarding of operative time and blood loss, there were no marked differences between the two types of OPLL, regardless of the type of surgical procedure; anterior decompression and fusion and anterior decompression via a posterior approach yielded longer operative times and larger blood loss volumes than expansive laminoplasty. Concerning clinical outcome, there were five cases of neurologic deterioration. All of the five deteriorated cases were of the beak-type OPLL treated by a posterior approach. Two of these patients were treated with expansive laminoplasty. CONCLUSIONS: There were five instances of neurologic deterioration in our thoracic OPLL series, and all of them exhibited beak-type OPLL. In the beak-type OPLL, a subtle alteration in the spinal alignment during posterior decompression procedures may increase spinal cord compression, leading to the deterioration of symptoms. A potential increase in kyphosis following laminectomy should be avoided by fixation with a temporary rod. If intraoperative monitoring suggests spinal cord dysfunction, an anterior decompression procedure should be attempted as soon as possible.

Decompression, Surgical↗

PubMed1979

Ossification of femoral head in infancy. II. Ossification in infants treated for congenital dislocation.

A review of the films obtained in 124 infants conservatively treated for congenital dislocation of the hip revealed deviations from ordinary development of the femoral head before as well as after the treatment. Analysis of these deviations suggested initial acceleration of ossification, modified by retardation ipsilateral to dislocation and followed by bilateral deceleration of growth after treatment.

Age Factors↗

PubMed1956