Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SPONDYLOSIS”

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 865 records · Page 48Linked to original sources
PubMed1997

A controlled study of diffuse idiopathic skeletal hyperostosis. Clinical features and functional status.

Diffuse idiopathic skeletal hyperostosis (DISH) is a common but little-studied disorder in the elderly that is infrequently recognized by physicians. Its prevalence in adults over 40 years of age is estimated at 3.8% for men and 2.6% for women. The present case-control study evaluated the history of pain and stiffness, radicular pain and enthesitis, physical findings on the musculoskeletal examination, and level of physical and psychologic disability in 130 persons: 56 patients with DISH, 43 control patients with spondylosis of the lumbar spine, and 31 healthy control patients. DISH patients were more likely to report a past history of upper extremity pain, medial epicondylitis of the elbow, enthesitis of the patella or heel, or dysphagia than spondylosis patients. They had more extremity and spinal stiffness and pain than healthy controls. DISH patients weighed more at a young age and their body mass index was greater at the time of the clinical evaluation than either spondylosis or healthy control patients. On musculoskeletal examination, DISH patients had a greater reduction in neck rotation and thoracic movements than either spondylosis patients or healthy controls, and had a greater reduction in lumbar movement than healthy controls. DISH patients had similar levels of spinal disability and physical disability overall, as measured by standardized indices, as spondylosis patients. No differences were found among the 3 groups of patients for the laboratory tests evaluated. DISH is clearly a distinct disorder with signs and symptoms that distinguish it from other causes of spinal complaint and from healthy individuals. It has the potential to cause major disability. Future studies need to address the natural history of DISH, pursue pathogenic mechanisms, and evaluate treatment modalities.

Activities of Daily Living↗
PubMed2006

Diffuse idiopathic skeletal hyperostosis associated with risk factors for stroke: a case-control study.

STUDY DESIGN: The incidence of risk factors for cerebrovascular diseases was investigated in patients with diffuse idiopathic skeletal hyperostosis (DISH) and patients with cervical spondylosis. OBJECTIVES: To investigate the association between DISH and cerebrovascular disease. SUMMARY OF BACKGROUND DATA: DISH is a common skeletal disease mainly affecting the anterior and lateral spinal longitudinal ligaments. The principal clinical features are nonradicular pain, stiffness, dysphagia (cervical portion), and associated ossification of the posterior longitudinal ligament. METHODS: Age- and sex-matched patients were divided into three groups: 45 patients with DISH, 45 patients with cervical spondylosis Grade I and II, and 45 patients with cervical spondylosis Grade III and IV. Anthropometric, laboratory, and magnetic resonance (MR) imaging findings were analyzed. RESULTS: The values of uric acid (P = 1.60 x 10) and alkaline phosphatase (P = 2.00 x 10) were significantly greater in patients with DISH than in the other groups. Patients with DISH had a significantly higher incidence of ossification of the posterior longitudinal ligament (P = 5.21 x 10). Stiffness was significantly more common in patients with DISH and patients with spondylosis Grade III and IV than in patients with spondylosis Grade I and II (P = 0.000232). The incidence of infarction on MR imaging was significantly higher in patients with DISH than in the other groups (P = 0.0120). The incidence of stenosis or occlusion of a major cerebral artery on MR angiography was significantly higher in patients with DISH than in the other groups (P = 0.00264). CONCLUSIONS: DISH is associated with increased incidences of risk factors for stroke and cerebrovascular disease.

Aged↗
PubMed1994

Preliminary findings on the effect of load-carrying to the structural integrity of the cervical spine.

Carrying loads on the head is a common practice in rural Zimbabwe. Headloading imposes a considerable amount of strain to the axial skeleton. The cervical spine, being the most cranial and mobile part of the vertebral column, may be susceptible to spondylosis or disc degeneration in headloading. Age as well as the effects of intrinsic factors on cervical spondylosis have been well documented. However, studies on the effect of extrinsic weight bearing to spondylosis on the cervical spine are lacking. In this study, the effect of headloading on the pattern of spondylosis attributed to aging was examined. Results indicated that age led to significant degeneration of the fifth intervertebral disc space (P < 0.05) as well as significant straightening of the lordotic curve (P < 0.01). Load carrying seems to accentuate the straightening of the curve (P < 0.001). The results also suggest that headloading creates a shift in the degeneration from the fifth intervertebral disc space to higher levels. It is concluded that carrying heavy loads on the head alters the pattern of degenerative changes of the cervical spine.

Adolescent↗
PubMed1997

MRI of car occupants with whiplash injury.

Our purpose was to document and investigate the prognostic significance of features seen on MRI of patients with whiplash injury following relatively minor road traffic crashes. MRI was obtained shortly and at 6 months after the crash using a 0.5 T imager. The images were assessed independently by two radiologists for evidence of fracture or other injury; loss of lordosis and spondylosis were also recorded. Clinical examinations were used to assess the status of patients initially and at 6 months. The results of the independent MRI and clinical investigations were then examined for association using statistical tests. Initial MRI was performed on 29 patients, of whom 19 had repeat studies at 6 months; 48 examinations were thus examined. Apart from spondylosis and loss of lordosis, only one abnormality was detected: an intramedullary lesion consistent with a small cyst or syrinx. There were no statistically significant associations between the outcome of injury and spondylosis or loss of lordosis. No significant changes were found when comparing the initial and follow-up MRI. It appears that MRI of patients with relatively less severe whiplash symptoms reveals a low frequency of abnormalities, apart from spondylosis and loss of lordosis, which have little short-term prognostic value. Routine investigation of such patients with MRI is not justified in view of the infrequency of abnormalities detected, the lack of prognostic value and the high cost of the procedure.

Accidents, Traffic↗
PubMed2003

Risk factors for outcome and complications of dorsal foraminotomy in cervical disc herniation.

BACKGROUND: Dorsal foraminotomy is a standard operative procedure for lateral cervical disc herniation. Factors associated with surgical complications and clinical outcome in dorsal foraminotomy of cervical disc herniation were evaluated in a retrospective cohort study. METHOD: Thirty-nine patients were operated upon for unilateral, monosegmental, mediolateral cervical disc herniation (+/- associated spondylosis) from 1997 to 1999. Preoperative radiologic imaging and surgical reports were analyzed. Motor disfunction, neck irritation, and radicular pain were evaluated. Outcome was ranked according to modified Odom's criteria at 6 weeks and 1 year postoperatively. RESULTS: Six weeks after injury 7 of 39 patients (18%) showed neck irritation. No new neurologic deficit was seen. All patients with preoperative paresis improved; two had early relapses of a medial soft disc prolapse (2/39). Residual radicular pain was seen in 3 of 39 patients (8%) within 30 days postoperatively, necessitating surgical revision. Factors of surgical failure were associated spondylosis (2/3) and residual mediolateral disc protrusion (1/3). In one patient with associated spondylosis, local pain due to a symptomatic fracture of the lateral process of D1 resolved after revision. Duration of preoperative radicular pain was identified as a risk factor for unfavorable outcome. CONCLUSION: In lateral cervical disc herniation, associated spondylosis or medial disc protrusion poses a significant risk of surgical failure and complications of dorsal foraminotomy. Reducing the radicular failure rate by enlarging the bony decompression may lead to local failure. In well-selected patients with a lateral cervical free disc fragment, dorsolateral foraminotomy is successful and safe.

Adult↗
PubMed1982

Radionuclide imaging of the neck in rheumatoid arthritis.

Blind marking was used to assess radionuclide neck images obtained with technetium-99m methylene diphosphonate in 28 patients with rheumatoid arthritis and 12 with cervical degenerative joint disease (spondylosis). Eleven out of the 16 rheumatoid arthritis patients who had neck pain when imaged showed enhanced uptake in the region of the atlantoaxial and temporomandibular joints. In contrast, no patient with cervical spondylosis and only one rheumatoid arthritis patient without neck pain had high uptake in either joint. Changes in uptake in this region on repeat imaging correlated significantly (P less than 0.01) with changes in pain. Patients with rheumatoid arthritis, with or without neck pain, and with cervical spondylosis showed similar patterns of radiological abnormality in the cervical spine. No detailed correlation was detected between radionuclide and radiographic findings. Radionuclide abnormalities were seen in the middle and lower cervical spine in both rheumatoid arthritis and cervical spondylosis. An abnormal radionuclide image of the middle or lower neck is thus of little value except when no degenerative change is present on the radiograph. An abnormal radionuclide image of the upper neck may be a useful indication of inflammation.

Arthritis, Rheumatoid↗
PubMed1990

Anterior cervical discectomy and fusion.

A retrospective review of 94 patients who had undergone anterior cervical discectomy and fusion was performed to analyze the result in patients who had a diagnosis of posterolateral spondylosis, disc herniation, or both. Although in 23 of 94 patients additional adjacent asymptomatic levels of spondylosis were noted, only the symptomatic levels were addressed in the 94 cases. Postoperatively two cases of dysphagia were noted, as well as a 4% pseudarthrosis rate. There was an 88% good or excellent result when no additional spondylosis was present, but only a 60% good or excellent result when just the symptomatic levels were addressed, leaving unoperated adjacent levels of spondylosis.

Adult↗
PubMed1989

Diffuse idiopathic skeletal hyperostosis: diagnostic significance of radiographic abnormalities of the pelvis.

Retrospective evaluation of the osseous pelvis in 93 patients with severe diffuse idiopathic skeletal hyperostosis (DISH) revealed 14 locations of radiographic abnormalities. Two osteoradiologists independently studied these sites for abnormalities in a prospective, blinded fashion in 103 patients over the age of 45 years. Lateral radiographs of the thoracolumbar spine were quantitatively and qualitatively evaluated to determine whether DISH, spondylosis deformans, or a normal spine was present. Statistical analysis was performed for evaluation of interobserver reliability, the relationship between pelvic and spinal abnormalities, and the significance and predictive values of pelvic abnormalities for DISH versus non-DISH and DISH versus spondylosis deformans. Although significantly higher frequencies and greater extents of radiographic abnormalities at 10 of 14 pelvic locations were noted for DISH compared with non-DISH, this number decreased to four of 14 locations when compared with spondylosis deformans. The alterations in three of these four pelvic sites consisted of ossification of ligaments. These changes appear to be good indicators of the presence of spinal DISH and support the concept that DISH is an entity separate from spondylosis deformans.

Adult↗
PubMed1990

[MR imaging of compressive cervical myelopathy after surgery--high signal intensity of the spinal cord on T2 weighted images].

We reviewed the MR images of 32 patients with cervical myelopathy, showing lesions of high signal intensity in the spinal cord on the sagittal T2 weighted images (T2WI) after surgery: 16 with OPLL; 9 with spondylosis; 4 with disc herniation and 3 with trauma. All images were obtained on a superconducting 1.5 Tesla system. The lesions were classified into five groups, according to the shape and grade of signal intensity on the sagittal T2WI: (I) oval-shaped lesion of signal intensity less brighter than CSF with blurred margin, (II) longitudinal linear-shaped lesion of signal intensity similar to CSF, (III) spindle-shaped lesion of signal intensity similar to CSF, (IV) round-shaped lesion of signal intensity similar to CSF and (V) mixed-types lesions which consisted of group I and II. The present study was summarized as follows: 1) Oval-shaped lesions were seen in the cases of disc herniation and spondylosis with relatively short duration of the symptom, presumptively with relatively short duration of the symptom, presumptively indicative of edema. 2) Most cases of OPLL and spondylosis showed linear-shaped lesions, suggesting necrosis and/or cavitations of the central gray matter. 3) One case of spondylosis developed a spindle-shaped lesion, implicating syringomyelia. 4) Round-shaped lesions were seen in the cases of spinal trauma, suggesting posttraumatic cyst. 5) In a case of mixed-typed lesion examined pre- and postoperatively, only an oval-shaped lesion decreased in size after surgery.

Adult↗
PubMed1989

Cervical kyphosis and myelopathy. Treatment by anterior corpectomy and strut-grafting.

Between 1976 and 1984, fourteen patients who had severe cervical kyphosis and myelopathy were treated with anterior decompression and arthrodesis. Eight had had spondylosis; five, a traumatic injury; and one, a benign intradural tumor. In eight of the fourteen patients, the severe kyphosis and myelopathy had developed after a laminectomy of three, four, or five cervical vertebrae. The laminectomy had been done for the treatment of spondylosis in five patients, of a traumatic lesion in two, and of a tumor in one. Considering all fourteen patients, an average of 2.25 vertebral bodies was removed from each, and the average extent of the subsequent fusion was 3.25 levels. Eight patients (six of whom had spondylosis; one, a traumatic lesion; and one, a tumor) were treated with a fibular graft that spanned an average of 4.10 levels, and six patients (four of whom had a traumatic lesion and two, spondylosis) were treated with an iliac graft that spanned an average of 2.70 levels. Of the five patients who had a traumatic lesion, four were treated with anterior decompression and arthrodesis, combined with posterior arthrodesis that was performed during the same period of anesthesia. In three patients, the anterior graft dislodged during the immediate postoperative period. Two of the three patients had posterior instability due to a prior laminectomy, and in the third the graft dislodged because of technical difficulties. Two of these grafts were revised to restore stability. At the latest follow-up, twelve of the fourteen fusions were solid. In the other two patients, who died six and ten months postoperatively, the fusion had been solid, as shown by radiographs, before the time of death. The average amount of correction of the kyphotic deformities was 32 degrees, a reduction from an average of 45 degrees to an average of 13 degrees. All but one patient had some recovery of neural function; nine had complete and four, partial recovery. The remaining patient had relief of pain, but he continued to be completely quadriplegic although he had some sensory sparing. Of the four patients who had been unable to walk preoperatively, three were able to walk postoperatively. No patient lost neural function after the anterior decompression and arthrodesis. We concluded that, in the presence of severe cervical kyphosis and myelopathy, adequate anterior decompression of the spinal cord, correction of the kyphosis, and anterior arthrodesis using a strut graft can yield excellent results without undue risk.

Adult↗
PubMed1977

Cervical spondylotic myelopathy with reversible fasciculations in the lower extremities.

Cervical spondylosis and motor system disease can appear in a similar manner with upper and lower motor neuron signs. Four patients with spasticity and fasciculations in the upper and lower extremities had surgical decompression for cervical spondylosis. Postoperative examinations at 24 to 48 months, including electromyographic studies, disclosed neurological improvement in all patients and loss of fasciculations in the lower extremities in three. Three mechanisms by which cervical spondylosis might cause fasciculations in the lower extremities are vascular insufficiency, cord traction, and denervation.

Adult↗
PubMed1995

Spinal abnormalities similar to ankylosing spondylitis in a 58-year-old woman with ochronosis.

Ochronotic arthropathy (spondylosis or peripheral arthropathy) is a late complication of alkaptonuria. There is a tendency for HLA-B27 positive patients with alkaptonuria to develop ochronotic spondylosis. A 58-year-old white woman, presented with ochronotic spondylosis. She was HLA-B27 positive. Her family history was positive for alkaptonuria. Ochronotic patients with HLA-B27 positivity develop spinal changes similar to ankylosing spondylitis (AS).

Alkaptonuria↗
PubMed2000

Sex difference in the validity of vertebral deformities as an index of prevalent vertebral osteoporotic fractures: a population survey of older men and women.

Morphometric methods have been developed for standardized assessment of vertebral deformities in clinical and epidemiologic studies of spinal osteoporosis. However, vertebral deformity may be caused by a variety of other conditions. To examine the validity of morphometrically assessed vertebral deformities as an index of osteoporotic vertebral fractures, we developed an algorithm for radiological differential classification (RDC) based on a combination of quantitative and qualitative assessment of lateral spinal radiographs. Radiographs were obtained in a population of 50- to 80-year-old German women (n = 283) and men (n = 297) surveyed in the context of the European Vertebral Osteoporosis Study (EVOS). Morphometric methods (Eastell 3 SD and 4 SD criteria, McCloskey) were validated against RDC and against bone mineral density (BMD) at the femur and the lumbar spine. According to RDC 36 persons (6.2%) had at least one osteoporotic vertebral fracture; among 516 (88.9%) nonosteoporotics 154 had severe spondylosis, 132 had other spinal disease and 219 had normal findings; 14 persons (2.4%) could not be unequivocally classified. The prevalence of morphometrically assessed vertebral deformities ranged from 7.3% to 19.2% in women and from 3.5% to 16.6% in men, depending on the stringency of the morphometric criteria. The agreement between RDC and morphometric methods was poor. In men, 62-86% of cases with vertebral deformities were classified as nonosteoporotic (severe spondylosis or other spinal disease) by RDC, compared with 31-68% in women. Among these, most had wedge deformities of the thoracic spine. On the other hand, up to 80% of osteoporotic vertebral fractures in men and up to 48% in women were missed by morphometry, in particular endplate fractures at the lumbar spine. In the group with osteoporotic vertebral fractures by RDC the proportion of persons with osteoporosis according to the WHO criteria (T-score < -2.5 SD) was 90.0% in women and 86.6% in men, compared with 67.9-85.0% in women and 20.8-50.0% in men with vertebral deformities by various methods. Although vertebral deformities by most definitions were significantly and inversely related to BMD as a continuous variable in both sexes [OR; 95% CI ranged between (1.70; 1.07-2.70) and (3.69; 1.33-10.25)], a much stronger association existed between BMD and osteoporotic fractures defined by RDC [OR; 95% CI between (4.85; 2.30-10.24) and (15.40; 4.65-51.02)]. In the nonosteoporotic group individuals with severe spondylosis had significantly higher BMD values at the femoral neck (p < 0.01) and lumbar spine (p < 0.0004) compared with the normal group. On the basis of internal (RDC) and external (BMD) validation, we conclude that assessment of vertebral osteoporotic fracture by quantitative methods alone will result in considerable misclassification, especially in men. Criteria for differential diagnosis as used within RDC can be helpful for a standardized subclassification of vertebral deformities in studies of spinal osteoporosis.

Aged↗
PubMed2006

Cervical spine abnormalities associated with Down syndrome.

Atlantoaxial instability (AAI) affects 10-20% of individuals with Down syndrome (DS). The condition is mostly asymptomatic and diagnosed on radiography by an enlarged anterior atlanto-odontoid distance. Symptomatic AAI, which affects 1-2% of individuals with DS, manifests with spinal cord compression. Cervical spondylosis, which is common in DS, also has the potential for cord damage but it has received less attention because paediatric populations were mostly studied. Forty-four Kuwaiti subjects with DS, whose ages were > or = 15 years, were evaluated clinically and radiographically. Lateral neck radiographs were taken in the neutral and flexion positions. Asymptomatic AAI was diagnosed in eight subjects (18%) and congenital anomalies of C1-2 were found in five (12%). Five patients had AAI in flexion only while three patients had it in both views. Three patients with AAI had odontoid anomalies contributing to the condition. When assessing AAI, the posterior atlanto-odontoid distance has to be considered because it indicates the space available for the cord. Cervical spondylosis was noted in 16 (36%) subjects. Degenerative changes increased with age, occurred earlier than in the normal population, and affected mostly the lower cervical levels. Half the patients with AAI had cervical spondylosis, a comorbidity that puts the cord at increased risk.

Adolescent↗
PubMed2005

Transforaminal steroid injections in the treatment of cervical radiculopathy. A prospective outcome study.

BACKGROUND: The aim of this study was to assess if transforaminal steroid injections applied to cohort of patients waiting for cervical disc surgery, reduce the pain of cervical radiculopathy and hence reduce the need for surgical intervention. Cervical radiculopathy due to cervical disc herniation or spondylosis is a common indication for cervical disc surgery. Surgery is however not always successful, and is not done without risk of complications. Transforaminal injection of steroids has gained popularity due to the rationale that inflammation of the spinal nerve roots causes radicular pain, and therefore steroids placed locally should relieve symptoms. METHODS: During a 12-month period, 21 secondary referral patients with unilateral cervical radiculopathy entered the study. Cervical disc herniation or spondylosis affecting the corresponding nerve root was demonstrated by appropriate investigation (MRI or myelography). The patients then received 2 transforaminal steroid injections, at 2 weeks interval, while waiting for operative treatment. The pain intensity (VAS), Odom's criteria and operative indications were registered at 6 weeks and 4 months. FINDINGS: After receiving injection treatment 5 of the 21 patients decided to cancel the operation due to clinical improvement. A statistically significant reduction (0.02) in radicular pain score was simultaneously measured. This corresponds well with the reduction in operative requirements since radicular pain is the main indication for operative treatment. The responders experienced a long-lasting effect. Those responding positively however improved neck pain to the same extent as radicular pain, and patients with cervical spondylosis responded as positively as those with disc herniation. INTERPRETATION: This prospective cohort study indicates a reduction in the need for operative treatment due to injection treatment. The clinical effect is measurable, and a statistically significant improvement of the radicular pain is registered. Routine transforaminal injection treatment prior to surgery seems rewarding, but the complication risk must be taken into consideration.

Adult↗
PubMed2003

Is atopic dermatitis a risk factor for intervertebral disc degeneration? A preliminary clinical and MRI study.

Atopic dermatitis (AD) is a common allergic disease that has recently been reported to be complicated with acute myelitis. To clinically evaluate the occurrence of myelitis in AD, 65 consecutive AD patients were neurologically examined. Of these, 37 underwent cervical MRI scans. Unexpectedly, the neurologic and MRI findings did not suggest myelitis, but rather, in most cases, cervical spondylosis. Therefore, we assessed the relationship between AD and cervical spondylosis. In addition, cervical MRI findings in 26 patients with multiple sclerosis (MS) and in 12 normal controls were also evaluated. The neurologic examinations in the AD patients frequently showed hyperreflexia in the legs, and sensory and motor disturbances were often present in the limbs. Cervical MRI findings suggestive of spondylosis, such as intervertebral disc degeneration and bulging/protrusion, were found more frequently in AD patients than in MS patients, with statistical significance. Posterior spondylolisthesis was observed with higher frequency in AD and MS patients than in normal controls. We concluded that AD might be a risk factor for intervertebral disc degeneration. As far as we know, this is the first paper describing the potential association between disc degeneration and AD.

Adolescent↗
PubMed2003

Cervical myelopathy in an adolescent with Hallervorden-Spatz disease.

Hallervorden-Spatz disease is a rare neurodegenerative disorder characterized by progressive dystonia, rigidity, and dementia. In these patients, chronic repeated dystonic movements, especially of the head and neck, can lead to excessive stress on the cervical spine, resulting in early degenerative changes and myelopathy. This report focuses on a young patient with Hallervorden-Spatz disease who presented with C4 to C5 cervical disk extrusion and cord compression because of premature spondylotic changes of the cervical spine. Other authors have documented cervical spondylosis caused by movement disorders, but there had been no reported cases of cervical myelopathy as a complication of Hallervorden-Spatz disease. Because these patients already manifest a longstanding and progressive neurologic disorder, clinicians may encounter difficulties recognizing the symptoms and signs of new cervical pathology, especially if the spondylosis and myelopathy has an insidious onset. For follow-up of patients with Hallervorden-Spatz disease who have multiple disabilities, a multidisciplinary approach with active involvement of physiotherapists, occupational and speech therapists, experienced nurses, caregivers, and clinicians is recommended. The clinician should also monitor the neurologic and functional status of the patient and screen for cervical pathology if suspicion arises. Good control of dystonia may be helpful in prevention of cervical spondylosis but may be difficult to achieve. Treatment modalities for dystonia are also discussed.

Adult↗
PubMed1992

Vertebral osteomyelitis following manipulation of spondylitic necks--a possible risk.

Neurological complications of neck manipulation are well recognised but are usually due to acute vascular incidents. However, we describe two patients with cervical spondylosis, who developed staphylococcal osteomyelitis of the cervical spine with progressive tetraplegia, apparently following manipulation of the neck by a chiropractor. Although it is possible that the manipulation resulted in cervical spine trauma sufficient to cause local haemorrhage, the area becoming a nidus for infection, it is also conceivable that the patients underwent neck manipulation in an attempt to relieve pain due to an already existing osteomyelitis of the cervical spine, and the manipulation may have hastened the onset of spinal cord paralysis. Clearly, this could have occurred, as the average time between the onset of symptoms and diagnosis of vertebral osteomyelitis in most published series is about 2 months. Approximately 80% of cases of osteomyelitis occur in the 50-70 age group, a group in which cervical spondylosis is extremely common. It would seem that neck manipulation is particularly contraindicated in older patients with cervical spondylosis.

Cervical Vertebrae↗