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European Spine Journal
Published in: European Spine Journal 2/2011

01-07-2011 | Case Report

Simultaneous ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum causing upper thoracic myelopathy in DISH: case report and literature review

Authors: Qunfeng Guo, Bin Ni, Jun Yang, Zhuangchen Zhu, Jian Yang

Published in: European Spine Journal | Special Issue 2/2011

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Abstract

A rare case of a 44-year-old Chinese male with diffuse idiopathic skeletal hyperostosis (DISH) and simultaneous ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF) at T1–2 causing thoracic myelopathy is reported herein. Posterior decompression without extirpating the OPLL was performed at T1–2. Postoperatively, symptoms were greatly improved, with remaining hyperreflexia and Grade 4/5 muscle strength in the lower extremities. The Japanese Orthopedic Association score improved from 5 preoperatively to 9 at final follow-up. The presence of a cyst due to leakage of cerebrospinal fluid was confirmed by MRI at day 27, but it resolved after conservative management. The clinical manifestation of DISH, the relationship among DISH, OPLL, and OLF, and management of thoracic myelopathy due to OPLL and OLF were reviewed.
Literature
1.
Matge G (2005) Surgical management of cervical radiculopathy in Forestier’s disease. Case report and review. Neurochirurgie 51:15–18PubMedCrossRef
2.
3.
4.
Pappone N, Di Girolamo C, Del Puente A, Scarpa R, Oriente P (1996) Diffuse idiopathic skeletal hyperostosis (DISH): a retrospective analysis. Clin Rheumatol 15:121–124PubMedCrossRef
5.
Chacko AG, Daniel RT (2007) Multilevel cervical oblique corpectomy in the treatment of ossified posterior longitudinal ligament in the presence of ossified anterior longitudinal ligament. Spine (Phila Pa 1976) 32:E575–E580CrossRef
6.
Jun BY, Yoon KJ, Crockard A (2002) Retro-odontoid pseudotumor in diffuse idiopathic skeletal hyperostosis. Spine (Phila Pa 1976) 27:E266–E270CrossRef
7.
8.
Patel NP, Wright NM, Choi WW, McBride DQ, Johnson JP (2002) Forestier disease associated with a retroodontoid mass causing cervicomedullary compression. J Neurosurg 96:190–196PubMed
9.
Goto S, Tanno T, Moriya H (1995) Cervical myelopathy caused by pseudoarthrosis between the atlas and axis associated with diffuse idiopathic skeletal hyperostosis. Spine (Phila Pa 1976) 20:2572–2575CrossRef
10.
Pascal-Moussellard H, Drossard G, Cursolles JC, Catonne Y, Smadja D (2006) Myelopathy by lesions of the craniocervical junction in a patient with forestier disease. Spine (Phila Pa 1976) 31:E557–E560CrossRef
11.
Griffiths ID, Fitzjohn TP (1987) Cervical myelopathy, ossification of the posterior longitudinal ligament, and diffuse idiopathic skeletal hyperostosis: problems in investigation. Ann Rheum Dis 46:166–168PubMedCrossRef
12.
Pouchot J, Watts CS, Esdaile JM, Hill RO (1987) Sudden quadriplegia complicating ossification of the posterior longitudinal ligament and diffuse idiopathic skeletal hyperostosis. Arthritis Rheum 30:1069–1072PubMedCrossRef
13.
Chiba H, Annen S, Shimada T, Imura S (1992) Atlantoaxial subluxation complicated by diffuse idiopathic skeletal hyperostosis. A case report. Spine (Phila Pa 1976) 17:1414–1417CrossRef
14.
Kawabori M, Hida K, Akino M, Yano S, Saito H, Iwasaki Y (2009) Cervical myelopathy by C1 posterior tubercle impingement in a patient with DISH. Spine (Phila Pa 1976) 34:E709–E711CrossRef
15.
Epstein NE (2000) Simultaneous cervical diffuse idiopathic skeletal hyperostosis and ossification of the posterior longitudinal ligament resulting in dysphagia or myelopathy in two geriatric North Americans. Surg Neurol 53:427–431 (discussion 431)PubMedCrossRef
16.
Razmi R, Khong KS (2001) Cervical cord injury in an elderly man with a fused spine—a case report. Singap Med J 42:477–481
17.
Alenghat JP, Hallett M, Kido DK (1982) Spinal cord compression in diffuse idiopathic skeletal hyperostosis. Radiology 142:119–120PubMed
18.
Reisner A, Stiles RG, Tindall SC (1990) Diffuse idiopathic skeletal hyperostosis causing acute thoracic myelopathy: a case report and discussion. Neurosurgery 26:507–511PubMedCrossRef
19.
Wilson FM, Jaspan T (1990) Thoracic spinal cord compression caused by diffuse idiopathic skeletal hyperostosis (DISH). Clin Radiol 42:133–135PubMedCrossRef
20.
Chi D, Miyamoto K, Hosoe H, Kawai G, Ohnishi K, Suzuki N, Sumi H, Shimizu K (2008) Symptomatic lumbar mobile segment with spinal canal stenosis in a fused spine associated with diffused idiopathic skeletal hyperostosis. Spine J 8:1019–1023PubMedCrossRef
21.
Utsinger PD (1985) Diffuse idiopathic skeletal hyperostosis. Clin Rheum Dis 11:325–351PubMed
22.
Crockard HA, Sett P, Geddes JF, Stevens JM, Kendall BE, Pringle JA (1991) Damaged ligaments at the craniocervical junction presenting as an extradural tumour: a differential diagnosis in the elderly. J Neurol Neurosurg Psychiatry 54:817–821PubMedCrossRef
23.
Ono M, Russell WJ, Kudo S, Kuroiwa Y, Takamori M, Motomura S, Murakami J (1982) Ossification of the thoracic posterior longitudinal ligament in a fixed population. Radiological and neurological manifestations. Radiology 143:469–474PubMed
24.
Ehara S, Shimamura T, Nakamura R, Yamazaki K (1998) Paravertebral ligamentous ossification: DISH, OPLL and OLF. Eur J Radiol 27:196–205PubMedCrossRef
25.
Resnick D, Guerra J Jr, Robinson CA, Vint VC (1978) Association of diffuse idiopathic skeletal hyperostosis (DISH) and calcification and ossification of the posterior longitudinal ligament. AJR Am J Roentgenol 131:1049–1053PubMed
26.
Hukuda S, Mochizuki T, Ogata M, Shichikawa K (1983) The pattern of spinal and extraspinal hyperostosis in patients with ossification of the posterior longitudinal ligament and the ligamentum flavum causing myelopathy. Skeletal Radiol 10:79–85PubMedCrossRef
27.
Wiberg C, Klatt AR, Wagener R, Paulsson M, Bateman JF, Heinegard D, Morgelin M (2003) Complexes of matrilin-1 and biglycan or decorin connect collagen VI microfibrils to both collagen II and aggrecan. J Biol Chem 278:37698–37704PubMedCrossRef
28.
Tsukahara S, Miyazawa N, Akagawa H, Forejtova S, Pavelka K, Tanaka T, Toh S, Tajima A, Akiyama I, Inoue I (2005) COL6A1, the candidate gene for ossification of the posterior longitudinal ligament, is associated with diffuse idiopathic skeletal hyperostosis in Japanese. Spine (Phila Pa 1976) 30:2321–2324CrossRef
29.
Havelka S, Vesela M, Pavelkova A, Ruzickova S, Koga H, Maeda S, Inoue I, Halman L (2001) Are DISH and OPLL genetically related? Ann Rheum Dis 60:902–903PubMed
30.
Yamazaki M, Mochizuki M, Ikeda Y, Sodeyama T, Okawa A, Koda M, Moriya H (2006) Clinical results of surgery for thoracic myelopathy caused by ossification of the posterior longitudinal ligament: operative indication of posterior decompression with instrumented fusion. Spine (Phila Pa 1976) 31:1452–1460CrossRef
31.
Hioki A, Miyamoto K, Hosoe H, Shimizu K (2008) Two-staged decompression for thoracic paraparesis due to the combined ossification of the posterior longitudinal ligament and the ligamentum flavum: a case report. Arch Orthop Trauma Surg 128:175–177. doi:10.​1007/​s00402-007-0336-5 PubMedCrossRef
32.
Tomita K, Kawahara N, Baba H, Kikuchi Y, Nishimura H (1990) Circumspinal decompression for thoracic myelopathy due to combined ossification of the posterior longitudinal ligament and ligamentum flavum. Spine (Phila Pa 1976) 15:1114–1120CrossRef
33.
Hanai K, Ogikubo O, Miyashita T (2002) Anterior decompression for myelopathy resulting from thoracic ossification of the posterior longitudinal ligament. Spine (Phila Pa 1976) 27:1070–1076CrossRef
34.
Fujimura Y, Nishi Y, Nakamura M, Toyama Y, Suzuki N (1997) Long-term follow-up study of anterior decompression and fusion for thoracic myelopathy resulting from ossification of the posterior longitudinal ligament. Spine (Phila Pa 1976) 22:305–311CrossRef
35.
Kurosa Y, Yamaura I, Nakai O, Shinomiya K (1996) Selecting a surgical method for thoracic myelopathy caused by ossification of the posterior longitudinal ligament. Spine (Phila Pa 1976) 21:1458–1466CrossRef
36.
Takahata M, Ito M, Abumi K, Kotani Y, Sudo H, Minami A (2008) Clinical results and complications of circumferential spinal cord decompression through a single posterior approach for thoracic myelopathy caused by ossification of posterior longitudinal ligament. Spine (Phila Pa 1976) 33:1199–1208CrossRef
37.
Matsumoto M, Chiba K, Toyama Y, Takeshita K, Seichi A, Nakamura K, Arimizu J, Fujibayashi S, Hirabayashi S, Hirano T, Iwasaki M, Kaneoka K, Kawaguchi Y, Ijiri K, Maeda T, Matsuyama Y, Mikami Y, Murakami H, Nagashima H, Nagata K, Nakahara S, Nohara Y, Oka S, Sakamoto K, Saruhashi Y, Sasao Y, Shimizu K, Taguchi T, Takahashi M, Tanaka Y, Tani T, Tokuhashi Y, Uchida K, Yamamoto K, Yamazaki M, Yokoyama T, Yoshida M, Nishiwaki Y (2008) Surgical results and related factors for ossification of posterior longitudinal ligament of the thoracic spine: a multi-institutional retrospective study. Spine (Phila Pa 1976) 33:1034–1041CrossRef
38.
Shen FH, Samartzis D (2007) Successful nonoperative treatment of a three-column thoracic fracture in a patient with ankylosing spondylitis: existence and clinical significance of the fourth column of the spine. Spine (Phila Pa 1976) 32:E423–E427CrossRef
Metadata
Title
Simultaneous ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum causing upper thoracic myelopathy in DISH: case report and literature review
Authors
Qunfeng Guo
Bin Ni
Jun Yang
Zhuangchen Zhu
Jian Yang
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue Special Issue 2/2011
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-010-1538-z

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