Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “OSSIFICATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed1993

The effect of indomethacin on heterotopic ossification following acetabular fracture surgery.

Sixty-six patients with acetabular fractures requiring a posterior or extensile surgical approach were treated using a uniform protocol that was begun in July 1984. In 1987, prophylactic Indomethacin was added to the protocol to study its effects on the prevention of heterotopic ossification. Forty-six patients were operated on prior to and 20 after the initiation of the Indomethacin treatment program. Patients were observed for at least 6 months and the incidence in severity of heterotopic ossification between groups was compared using the Brooker classification. Patients' were also evaluated for associated risk factors. Statistical analysis revealed that the male sex and the extensile approach were the significant risk factors (p < 0.01). Evaluation of drug treatment revealed that while Indomethacin was not effective in completely eliminating heterotopic ossification, the occurrence of severe heterotopic ossification (Brooker Class III and Class IV) was significantly reduced (p < 0.05).

Acetabulum↗
PubMed1999

Ankylosed hips caused by heterotopic ossification after traumatic brain injury: a difficult problem.

BACKGROUND: Heterotopic ossifications develop around major joints after severe traumatic brain injury and decrease the range of motion of the joints. METHODS: From 1982 to 1994, we operated on 22 ankylosed hips caused by heterotopic ossifications after traumatic brain injury. Our 15 patients had been hospitalized in the intensive care unit for a period of 8 to 57 days. Their preoperative neurologic status was evaluated precisely. Special interest was given also to the accurate estimation of the extent and location of the ectopic bone by using x-rays and computed tomography, as well as to the maturity of the bone by using Tc99 bone scan and measurements of serum alkaline phosphatase levels. Intraoperatively, we resected as much ectopic bone as was needed to achieve functional range of motion in the hip. Postoperatively, all the patients were administered 100 mg of indomethacin (suppository) per day for a month, antibiotics, and anticoagulants. They were also exposed to 1,000 cGy of radiation in two equal doses. RESULTS: We achieved a least functional range of motion in 15 of 22 hips. Of the seven hips with poor results, six cases were attributable to the uncontrolled neurologic syndrome and only one poor result was attributable to severe heterotopic ossification recurrence. Wound complications did occur. CONCLUSION: Ankylosed hips caused by heterotopic ossifications after traumatic brain injury are a difficult problem to manage. Accurate evaluation of the preoperative neurologic status is essential for the desired final outcome and the treatment options.

Adult↗
PubMed1992

The role of calcium metabolism abnormalities in the development of ossification of the posterior longitudinal ligament of the cervical spine.

To study the role of calcium metabolism in the development of ossification of the posterior longitudinal ligament of the cervical spine, 39 patients with affected cervical spines were investigated using an oral calcium tolerance test and followed by cervical spinal radiography to evaluate disease progression. The average follow-up was 6 years. The patients were divided into two groups according to their responsiveness to an oral calcium load: a group of 14 patients with decreased calciuric responses and another group of 25 with normal responses. The incidence of the development of cervical ossification of the posterior longitudinal ligament in the decreased-response group was significantly higher than that in the normal group. Because these patients were managed operatively by laminoplasty, however, the incidence was low irrespective of their calciuric responses. These results suggest that the development of cervical ossification of the posterior longitudinal ligament is associated with decreased intestinal calcium absorption but that treatment with laminoplasty alters the mechanical environment of the cervical spine (eg, range of motion of the cervical spine is limited). The development of cervical ossification of the posterior longitudinal ligament may be controlled by this procedure.

Aged↗
PubMed1998

Magnetic resonance imaging of the spinal cord in cervical ossification of the posterior longitudinal ligament. Can it predict surgical outcome?

STUDY DESIGN: Magnetic resonance imaging findings of an increased signal in the cervical cord in patients undergoing surgery for ossification of the posterior longitudinal ligament were analyzed to determined whether an increased signal on T2-weighted images correlated with a poorer outcome. OBJECTIVES: To clarify whether preoperative magnetic resonance imaging findings of a high signal in the cord constitute a poor prognostic factor. SUMMARY OF BACKGROUND DATA: The importance of a high, T2-weighted, intramedullary signal on preoperative magnetic resonance studies in patients undergoing surgery for ossification of the posterior longitudinal ligament requires further clarification. METHODS: Of 91 patients having cervical surgery for ossification of the posterior longitudinal ligament, 26 had a history of minor trauma. High, T2-weighted signals in the cord were noted in 23 patients who had sustained trauma and in 39 patients who had no history of trauma. Patients were divided into four groups according to the presence or absence of a high cord signal and/or a trauma history. Pre- and postoperative Japanese Orthopaedic Association scores and recovery ratios then were evaluated. RESULTS: The pre- and postoperative Japanese Orthopaedic Association scores and recovery ratios of the patients with a high signal and a trauma history were significantly less than those with no high signal but with a trauma history. Among the patients with no history of trauma, however, there were no significant differences in the pre- and postoperative JOA scores and recovery ratios between the patients with a high signal and those with no high signal. CONCLUSION: A high preoperative cord signal on T2-weighted magnetic resonance images for patients undergoing surgery for ossification of the posterior longitudinal ligament constitutes a poor prognostic factor, when trauma has played a role.

Adult↗
PubMed2000

Atlantoaxial subluxation associated with ossification of posterior longitudinal ligament of the cervical spine.

STUDY DESIGN: Two case reports. OBJECTIVE: To demonstrate two rare cases of atlantoaxial subluxation associated with ossification of the posterior longitudinal ligament of the cervical spine, in which spastic quadriplegia developed. SUMMARY OF BACKGROUND DATA: There are only two reports of an association of diffuse idiopathic skeletal hyperostosis with atlantoaxial subluxation. This condition often accompanies ossification of the posterior longitudinal ligament of the cervical spine, but there is nothing in the literature about the association of ossification of the posterior longitudinal ligament with atlantoaxial subluxation. METHODS: Clinical and radiographic findings of these two cases were demonstrated. In both cases laminoplasty of the cervical spine was performed with occipitoaxial arthrodesis. RESULTS: The spastic quadriplegia of these two patients caused by myelocompression improved after surgical intervention. CONCLUSION: Ossification of the posterior longitudinal ligament of the cervical spine may cause atlantoaxial subluxation.

Aged↗
PubMed2001

Long-term follow-up results of anterior interbody fusion applied for cervical myelopathy due to ossification of the posterior longitudinal ligament.

STUDY DESIGN: A long-term follow-up study was carried out in 30 patients who underwent anterior interbody fusion for cervical myelopathy associated with ossification of the posterior longitudinal ligament (OPLL). OBJECTIVE: To investigate whether anterior interbody fusion without decompression is an appropriate surgical method for long-term relief of cervical OPLL myelopathy. SUMMARY OF BACKGROUND DATA: Several studies of operative results after posterior decompression for cervical myelopathy due to ossification of the posterior longitudinal ligament have been reported. There has been no report about anterior interbody fusion without decompression. The postoperative results of this treatment method applied in cervical OPLL myelopathy have been evaluated by the authors of the present study for more than 10 years. No reports on such a long-term follow-up study have been published in the literature. METHODS: Thirty patients who underwent anterior interbody fusion for cervical OPLL myelopathy were evaluated clinically and radiographically. The mean follow-up period was 14.7 years (range, 10-23 years). RESULTS: Clinical results were evaluated according to Okamoto's classification. At the time of the final follow-up evaluation, 16 patients had improved in functional score by two grades, and their surgical results were regarded as excellent; eight patients improved by one grade, and their clinical outcomes were regarded as good; five patients showed no change; and the condition of one patient deteriorated. As for radiographic analysis, the type of ossification had changed in four cases. Ossification width and thickness increased in 26 patients. Postoperative alignment of the cervical spine showed kyphosis in three patients, straight spine in 11 patients, and lordosis in 16 patients. CONCLUSION: Anterior interbody fusion without decompression is an effective treatment for cervical OPLL myelopathy that resulted in stable long-lasting conditions.

Adult↗
PubMed2001

Quality of life in elderly patients with ossification of the posterior longitudinal ligament.

STUDY DESIGN: A longitudinal cohort study of 216 elderly patients with ossification of the posterior longitudinal ligament for an average of 13 years was performed. OBJECTIVE: To know the quality of life experienced by patients after treatment. SUMMARY OF BACKGROUND DATA: No report is available on the quality of life experienced by elderly patients with ossification of the posterior longitudinal ligament. Because the life prognosis of patients with this condition is relatively good, the quality of life experienced by elderly patients with this disease is an important subject. METHODS: The study participants were 216 elderly patients with ossification of the posterior longitudinal ligament. Conservative therapy was performed for 126 patients, and surgical therapy for 90 patients. Surgery was basically indicated for patients with myelopathy, who were classified using Nurick's grading system. The cumulative survival rate of these patients and their disabilities in daily living were reviewed. The occurrence of fracture resulting from osteoporosis was surveyed, and the relation of such fractures to bone mineral density was examined. RESULTS: The cumulative survival rate of 70-year-old patients exhibiting Nurick Grade 5 severe myelopathy before treatment was 20%, whereas that of patients without myelopathy or those with Grades 1, 2, 3, or 4 myelopathy before treatment was 80%. Patients who underwent surgical therapy for Grade 3 or 4 myelopathy were statistically more likely to be independent of assistance with activities of daily living than those with similar degrees of myelopathy who underwent conservative therapy. The final quality of life was poor for patients with Grade 5 myelopathy at the first examination, regardless of therapeutic method. The prevalence of complication by fracture in patients with ossification of the posterior longitudinal ligament was 1.4% for men and 8.6% for women. The bone mineral density in these patients without myelopathy was significantly higher than in healthy subjects of the same age. CONCLUSION: The study data suggest that surgical treatment should be chosen for patients exhibiting moderate myelopathy to obtain satisfactory quality of life for them over a long period.

Absorptiometry, Photon↗
PubMed2002

Possible roles of CTGF/Hcs24 in the initiation and development of ossification of the posterior longitudinal ligament.

STUDY DESIGN: A biochemical and histochemical study investigating the role of CTGF/Hcs24 in the ossification of the posterior longitudinal ligament (OPLL) was conducted. OBJECTIVE: To clarify the involvement of CTGF/Hcs24 in ectopic bone formation in OPLL through endochondral ossification using human tissue. SUMMARY OF BACKGROUND DATA: Previous studies have shown that various cytokines are involved in the occurrence or development of ectopic bone formation in OPLL. Recently, the authors cloned an mRNA predominantly expressed in chondrocytes by differential display PCR and found that its gene, hcs24, is identical to that of connective tissue growth factor. It has been shown that CTGF/Hcs24 plays a major role in endochondral ossification. METHODS: Ossified ligament tissues were taken from seven male OPLL patients during surgery. Immunohistochemical staining was performed using an antibody specific for CTGF/Hcs24. Spinal ligament cells were isolated from five OPLL patients as well as five non-OPLL patients. The cells were incubated with recombinant human CTGF/Hcs24 or TGFbeta. The expression of ALP was analyzed by RT-PCR. For the effects of TGFbeta, the expression of CTGF/Hcs24 mRNA was analyzed. RESULTS: Immunohistochemical staining showed that chondrocytes in the transitional region from nonossified to ossified ligament were stained with an antibody against CTGF/Hcs24. It was found that CTGF/Hcs24 enhanced the expression ALP mRNA in OPLL cells, whereas the expression remained unchanged in non-OPLL cells. The expression of CTGF/Hcs24 mRNA in OPLL and non-OPLL cell lines was increased by TGFbeta, and there was no significant difference between the two groups. However, TGFbeta and CTGF/Hcs24 enhanced the expression of ALP mRNA only in OPLL cells. CONCLUSIONS: According to the study results, CTGF/Hcs24 may not only be an important factor in the development of endochondral ossification in OPLL, but may also be responsible for initiating osteogenesis in spinal ligament cells.

Adult↗
PubMed2002

Paraparesis in a black man brought on by ossification of the ligamentum flavum: case report and review of the literature.

We present the second case of paraparesis secondary to ossification of the ligamentum flavum at the midthoracic region in a black man. Ossification of the ligamentum flavum is frequently described in the Japanese population where the presentation is often in the lower thoracic region. The patient is a 37-year-old black man who, over the 6 months before admission, noticed progressive paraparesis. CT myelogram revealed severe thoracic stenosis by an ossified ligamentum flavum from T4 to T7 with most severe involvement at the T5, T6, and T7 levels. The patient underwent multilevel laminectomies and medial facetectomies from T4 to T7. Over the past decade, ossification of the ligamentum flavum has been reported with increasing frequency in non-Asian patients. This is the third case report in a black man. In addition, ossification of the ligamentum flavum in this particular location is rarely reported. The increased use of advanced neuroimaging techniques in the evaluation of "back pain" may reveal that the prevalence of this condition is higher than expected in non-Asian populations. Improvement in neurologic symptoms secondary to decompressive laminectomies will depend on the degree and duration of spinal cord compression.

Adult↗
PubMed2003

Association between polymorphism of the transforming growth factor-beta1 gene with the radiologic characteristic and ossification of the posterior longitudinal ligament.

STUDY DESIGN: A study was conducted to examine the relation between the transforming growth factor-beta1 (TGF-beta1) polymorphism (T-->C transition in the signal sequence) and ossification of the posterior longitudinal ligament (OPLL). OBJECTIVE: To investigate the association between the polymorphism of TGF-beta1 and the radiologic characteristics of OPLL. SUMMARY OF BACKGROUND DATA: Ossification of the posterior longitudinal ligament has a strong genetic background. Several genes contribute to the expression of OPLL. Transforming growth factor-beta1 is present in the ossified matrix and chondrocytes of cartilage adjacent to areas of OPLL. METHODS: The difference in the TGF-Tbeta1 allele distribution ("TT," "TC," and "CC") between 369 patients with OPLL and 258 control subjects was assessed. The relations between the allele frequency and radiologic features of OPLL involving the cervical, thoracic, and lumbar spine and the width of the ossification area were evaluated. RESULTS: There was no statistical difference with respect to the type of OPLL and the width of the ossification area for the TGF-Tbeta1 allele between the OPLL and the control groups. However, in the patients with "TC" or "CC" alleles, OPLL frequently was found in the cervical, thoracic, and/or lumbar spine. CONCLUSIONS: Transforming growth factor-beta1 polymorphism is not a factor associated with the occurrence of OPLL, but rather a factor related to the area of the ossified lesion. The "C" allele might be a risk factor for patients with OPLL in other areas in addition to the cervical lesion.

Aged↗
PubMed2006

How does the ossification area of the posterior longitudinal ligament progress after cervical laminoplasty?

STUDY DESIGN: Retrospective case series. OBJECTIVE: To investigate the progression pattern of ossification of the posterior longitudinal ligament (OPLL) after cervical laminoplasty. SUMMARY OF BACKGROUND DATA: OPLL is a progressive disease, and an increased area of ossification affects the surgical results after laminoplasty. However, it is uncertain how the ossification area progresses with time after surgery. METHODS: Fifty-five patients who were available for serial radiographs of more than 5 years were included. The extent of ossification in the longitudinal axis was assessed using computer software. The associations between the progression of OPLL and the clinical and radiologic data were analyzed. RESULTS: Forty-one patients had OPLL progression. The patients were divided into three groups according to the pattern of progression. Group 1 consisted of patients 40 to 49 years of age with continuous or mixed type, showing slow progression at the beginning, then fast. Group 2 consisted of patients older than 50 years with continuous or mixed type, showing rapid progression at the beginning and then slow. The patients in Group 3 had segmental type with no or slight progression. CONCLUSIONS: We speculated that the progression of OPLL decreases as the patient ages. These findings will be important for the management of patients with OPLL after surgery.

Adult↗
PubMed2004

Multifactorial refractory heterotopic ossification.

Ectopic bone formation or "heterotopic ossification" can follow surgery, trauma, or neurologic injury, but the process is usually self-limited, localized to the site of injury, and responds to surgical treatment when necessary. Aggressive, systemic forms of heterotopic ossification exist that generate lesions that often resist surgical treatment and produce a high rate of recurrence. These entities typically manifest during infancy as genetic syndromes such as fibrodysplasia ossificans progressiva or progressive osseous heteroplasia. The authors describe a case of aggressive, systemic heterotopic ossification in an adult that followed a motor vehicle accident and multiple surgeries. The patient developed a large nonhealing wound around a focus of ectopic bone. Skin grafts failed as a result of the recurrence of ectopic bone, and the patient eventually required aggressive debridement and delayed rotational flap closure. A brief review of the clinical features and surgical treatment of heterotopic ossification is outlined.

Accidents, Traffic↗
PubMed1995

Heterotopic ossification induced by hypoxia in a retrosternal gastric tube following transhiatal oesophagectomy.

A 71 year old man underwent retrosternal gastric tube reconstruction following transhiatal oesophagectomy for squamous cell carcinoma. On the second post-operative day, the patient developed a cardiac arythmia with secondary hypotension followed by hypoxaemia necessitating artificial ventilation. Two weeks after surgery, endoscopy revealed massive necrosis of the proximal segment of the gastric tube extending from the anastomosis in the neck to the watershed area. Three weeks later, the patient died and a necropsy was performed. Macroscopic evaluation of the gastric tube revealed a sharply demarcated and fully ossificated proximal segment. Heterotopic ossification was present on histological examination. This condition has only been described in conjunction with primary or metastatic gastric adenocarcinoma. The location of the ossification and the presence of temporary systemic hypoxia suggest that the latter was the main factor responsible for the ossificative response.

Aged↗
PubMed1987

Ossification of the posterior longitudinal ligament: a clinico-radiological study of 74 cases.

A clinico-radiological analysis of 74 cases of ossification of the posterior longitudinal ligament is reported. Eighteen cases (24%) were asymptomatic or only had neck or shoulder pain; 16 cases (22%) showed signs of radiculopathy, and the remaining 40 cases (54%) had myelopathy. Ossification of the posterior longitudinal ligament developed most frequently at C5, and was rare in thoracic and lumbar regions. Ossification of the posterior longitudinal ligament led to stenosis of the spinal canal; more marked stenosis caused clinical myelopathy. The data showed that 30% of stenosis caused by ossification of the posterior longitudinal ligament was critical for the production of myelopathy.

Adult↗
PubMed1985

Labyrinthine ossification: etiologies and CT findings.

Ossification of the membranous labyrinth (labyrinthitis ossificans) develops as the final result of many inflammatory processes, for example, meningitis, blood-borne septic emboli, middle ear infection, and cholesteatoma. Labyrinthine ossification may also occur as a result of previous labyrinthectomy or secondary to trauma. Seven cases of labyrinthine ossification accompanied by severe vertigo and total hearing loss in the affected ear are discussed. The computed tomographic appearance of varying degrees of ossification, the clinical and surgical circumstances from which this disorder may develop, and the various approaches to labyrinthectomy are described.

Adult↗
PubMed1990

Spinal cord compression due to ossification of ligaments: MR imaging.

A total of 108 patients with ossification of the posterior longitudinal ligament (OPLL) (n = 92), ossification of the yellow ligament (OYL) (n = 8), or both (n = 8) were examined with magnetic resonance (MR) imaging performed with 0.5-T superconductive and 0.22-T resistive units. OPLL was demonstrated as a low-signal-intensity band between the bone marrow of the vertebral body and the dural sac on T1- and T2-weighted images. Continuous cervical OPLL was easier to diagnose than segmental cervical OPLL. T2-weighted images were more useful for detection of ossification of the ligaments. OYL was recognized as an impression on the posterior dural sac. Formation of bone marrow within an area of ossification, shown as increased or intermediate signal intensity, was observed in 56% of the cases of continuous OPLL, 11% of the cases of segmental OPLL, and none of the cases of OYL. The degree of cord compression was more severe in continuous OPLL. Degeneration of the disk was frequently associated with both types of OPLL.

Adult↗
PubMed1987

Diffuse pulmonary ossification associated with metastatic melanoma of the lung.

A case with advanced diffuse pulmonary ossification is described. The patient underwent surgical treatment of a malignant nodular melanoma of the right shoulder followed by postoperative cytostatic therapy for 6 months. He developed renal insufficiency and pulmonary infiltrates 3 years after the operation. Two metastases into the lung were operated 4 years after extirpation of the melanoma. Histopathological findings revealed two major metastases of a malignant amelanotic melanoma and multiple tumour thromboses in lymphatic and venous vessels. Severe interstitial lung damage including diffuse pulmonary ossification and focal interstitial fibrosis was noted. Morphometric measurements of ossified nodules revealed increased ossification in fibrotic lung areas. Immunohistology for differentiating immunoglobulins and lymphocytic subpopulations was insuspicious. The findings suggest that diffuse intraalveolar ossification is probably not related to pulmonary congestion.

Biopsy↗
PubMedDate not supplied

Posterior ossification of the shoulder: the Bennett lesion. Etiology, diagnosis, and treatment.

We report a series of ossific lesions of the posterior inferior glenoid in a group of elite baseball players. We hope to clarify the etiology, diagnosis, and treatment of the Bennett lesion. From August 1985 to August 1991, we identified six professional baseball pitchers and one college pitcher with evidence of ossification of the shoulder on plain radiographs, computed tomography, or magnetic resonance imaging. Arthroscopic examination was performed in all cases. All seven players had identifiable posterior labral injury on arthroscopic examination; six of these seven also had varying degrees of undersurface posterior rotator cuff damage. No anterior tissue damage, anterior instability, or subacromial impingement was noted. No ossification was identified arthroscopically. Intraarticular labral and rotator cuff tears were debrided arthroscopically and patients underwent rehabilitation for 4 to 6 months after surgery. Six of the seven athletes returned to preinjury performance levels; however, one pitcher is no longer playing competitive baseball. The Bennett lesion is an extraarticular posterior ossification associated with posterior labral injury and posterior undersurface rotator cuff damage. It is not, however, a result of traction stresses in the region of the triceps insertion. Recognition is important for identification and treatment of the lesion and associated pathologic damage.

Adolescent↗