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At least 1,189 records · Page 66Linked to original sources
PubMed1994

Ossification of the posterior longitudinal ligament: a report of nine cases in non-Oriental patients.

Ossification of the posterior longitudinal ligament (OPLL) is a progressive disorder of the spine which may result in spinal cord compression and myelopathy. While prevalent among Japanese, its occurrence in non-Orientals has been infrequently reported. Nine patients with OPLL have been diagnosed and followed at the Emory Clinic Spine Center over a 5-year period. All of the patients had been misdiagnosed before presentation. Five of the nine had undergone a total of eight ineffective operations. Failure to distinguish OPLL from other more common causes of myelopathy can result in delayed or inappropriate treatment. Illustrative cases and radiographic studies are presented.

Adult↗
PubMed1987

[Tibiofibular mobility and arthrosis in patients with postoperative ossification in the area of syndesmosis of the upper ankle joint].

Subject of this investigation is the influence of postoperative tibio-fibular ossification on the development of arthrosis of the ankle. Changes of the biomechanics of the joint can be evaluated by computed tomography. Posttraumatic and postoperative changes of the mobility of the fibular in relation to the tibia may be quantified by CT investigation and evaluated with respect to the development of arthrosis.

Aged↗
PubMed1989

Human penile ossification: a case report and review of the literature.

Human penile ossification is a rare event. Only a limited number of cases have appeared in the literature. Several reported cases have been related to local trauma and plastic induration of the penis. We report an additional case with a comprehensive review of case reports in the literature.

Humans↗
PubMed2002

Polyarticular heterotopic ossification complicating drug-induced coma.

The authors describe a case of generalised heterotopic ossification (HO) complicating the clinical course of a 31-year-old male patient with a history of Hodgkin's lymphoma and of long stay in an intensive care unit, where he had been placed in an artificial coma. The clinical features, as well as radiological findings and therapy, are discussed.

Adrenal Cortex Hormones↗
PubMed2003

Preoperative irradiation for prevention of heterotopic ossification following prosthetic total hip replacement results of a prospective study in 462 hips.

BACKGROUND: The effectiveness of pre- or postoperative radiotherapy for prevention of heterotopic ossification (HO) following total hip replacement (THR) has already been demonstrated in the past. Thereby, in most studies using preoperative radiotherapy patients were irradiated < 6 h before surgery. The purpose of this prospective study was to analyze the effectiveness of preoperative irradiation on the evening before surgery and to identify risk factors for HO in a homogeneous collective of patients. PATIENTS AND METHODS: From July 1997 to July 2001, 416 patients (462 hips; 235 males, 227 females) received preoperative radiotherapy of the hip on the evening before surgery with a 7-Gy single fraction. The patients' median age was 67.1 years. The most frequent indication for radiotherapy was hypertrophic osteoarthritis (383 hips, 82.9%). Treatment results were assessed by comparison of pre- and postoperative hip X-rays (immediately and 6 months after surgery). The analysis of radiographs was performed according to the Brooker score. RESULTS: The overall incidence of HO was 18.1% (n = 84), Brooker score 1 12.3% (n = 57), score 2 3.9% (n = 18), score 3 1.5% (n = 7), and score 4 0.4% (n = 2). Sex, body height, hypertrophic osteoarthritis of higher degree, size of the femoral component of the prosthesis, previous ipsi- or contralateral HO, and short course of nonsteroidal anti-inflammatory drug (diclofenac) therapy significantly influenced the HO rate in univariate analysis. In multivariate analysis, an interdependence of prosthesis size, sex and patient's height was found. From these three variables, only prosthesis size was statistically significant in multivariate analysis. The cumulative dose of diclofenac (< or = 300 mg or > 300 mg) within the first 7 postoperative days and previous ipsi- or contralateral HO influenced the incidence of HO in multivariate analysis. CONCLUSION: Preoperative radiotherapy on the evening before surgery is an effective treatment modality to reduce overall (Brooker 1-4) and clinically relevant, severe HOs (Brooker 3-4), and includes several advantages compared to postoperative irradiation. Previous ipsi- and contralateral HOs were identified as high risk factors for HO in this study. In patients with these risk factors, the incidence of HO increased.

Adult↗
PubMed2000

[Bilateral hip ankylosis caused by heterotopic ossification after isolated severe craniocerebral trauma].

A 36-year old man suffered an isolated head injury with a fracture of the skull, epidural and subdural hematomas as well as brain contusion (Abbreviated Injury Scale (AIS): 5 points). The hematomas were evacuated by craniotomy. Because of high intracranial pressure (ICP) a barbiturate coma was necessary. Additionally, the patient demonstrated acute lung injury (ARDS) due to pneumonia 8 days after trauma. The patient recovered slowly and was transferred to neurorehabilitation on day 57 after injury. During the following 12 months the patient developed a significant deficit of hip motion (extension/flexion: right: 0 degree/10 degrees/20 degrees, left: 0 degree/10 degrees/30 degrees; external/internal rotation: right and left: < 5 degrees/0 degree/< 5 degrees; abduction/adduction: right: 10 degrees/0 degree/25 degrees, left: 10 degrees/0 degree/10 degrees). X-rays and CT-scanning revealed severe heterotopic ossification (HO) of both hips with ancylosis (Brooker type IV). Resection of HO was carried out in a two stage procedure using Smith-Petersen approach. The prophylaxis for recurrence of HO included preoperative single-dose radiation (8 Gy) and postoperative treatment with indomethacin (150 mg per day). The patient revealed 15 (left hip) and 12 (right hip) months after surgery the following range of hip movement: extension/flexion: right: 5 degrees/0 degree/90 degrees, left: 5 degrees/0 degree/100 degrees; external/internal rotation: right: 20 degrees/0 degree/30 degrees, left: 20 degrees/0 degree/20 degrees; abduction/adduction: right: 30 degrees/0 degree/40 degrees, left: 30 degrees/0 degree/40 degrees. No recurrence of HO was observed in x-ray. The patient is able to work in his profession as farmer.

Adult↗
PubMed1996

Significance of serum levels of type I procollagen peptide and intact osteocalcin and bone mineral density in patients with ossification of the posterior longitudinal ligaments.

This study was performed to evaluate the correlation between serum biochemical marker levels of bone metabolism and bone mineral density (BMD) in patients with ossification of the posterior longitudinal ligaments (OPLL). In addition, the efficacy of these markers in the prediction of the progression of OPLL was also examined. In 40 patients with OPLL, and in age- and gender-matched controls (n = 36), the levels of C-terminal extension peptide of type I procollagen (PICP) and intact osteocalcin were quantitated by a sandwich enzyme-linked immunosorbent assay as serum markers of bone formation. BMD of the whole body was measured using dual-energy X-ray absorptiometry. Serum PICP and intact osteocalcin levels were significantly increased in patients with OPLL. There was a significant correlation between serum bone formation marker levels and BMD in both the OPLL and the control groups. Patients with radiological progression of OPLL showed a level higher than the mean + 2 SD of controls in PICP, intact osteocalcin, and BMD. In addition, the levels of serum PICP and intact osteocalcin increased in correspondence with the progression of OPLL without statistical significance. In patients without any growth of OPLL, however, all the parameters were below the mean + 2 SD of controls. Thus, aggravation of bone formation activity was suggested to be closely correlated with the development of OPLL. In addition, serial measurements of these parameters might be useful for estimating the progression of OPLL.

Adult↗
PubMed1997

Bone morphogenetic protein-2 stimulates differentiation of cultured spinal ligament cells from patients with ossification of the posterior longitudinal ligament.

Ossification of the posterior longitudinal ligament (OPLL) of the spine is characterized by heterotopic bone formation occurring in spinal ligament, causing severe compression myelopathy. In order to investigate the mechanism of OPLL development, we isolated spinal ligament cells from OPLL patients as well as non-OPLL patients, and established 10 OPLL cell lines and 7 non-OPLL cell lines, respectively. We analyzed the effects of bone morphogenetic protein-2 (BMP-2) on these cells with respect to alkaline phosphatase (AP) activity, DNA synthesis, and collagen production. BMP-2 caused a significant increase of AP activity in 4 OPLL cell lines, whereas the activity did not change in any non-OPLL cells. Among OPLL cells, BMP-2 stimulated DNA synthesis in four cell lines and procollagen type I carboxyl-terminal peptide (PICP) synthesis in five cell lines. Some non-OPLL cells also responded to BMP-2, as there was an increase of DNA synthesis in three cell lines and PICP synthesis in one cell line. These data collectively indicate that BMP-2 preferentially induces osteogenic differentiation in OPLL cells rather than in non-OPLL cells. OPLL cells, therefore, exhibit a different response to BMP-2 than non-OPLL cells, suggesting that the expression of BMP receptor(s) and/or the signal transduction initiated by BMP-2 in the spinal ligament cells of OPLL patients somewhat deviate from those in normal spinal ligament cells. Such abnormal characteristics of OPLL cells as described here provide some clues to the clarification of the pathogenesis of OPLL.

Alkaline Phosphatase↗
PubMed1996

Avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissue.

Patients who have sustained an avulsion fracture and present clinically during the healing phase of the injury may manifest a mass that clinically and radiographically mimics a malignant neoplasm. A 15-year-old male soccer goalkeeper presented with a large ossified mass in the soft tissues overlying the right hip 6 months after experiencing a popping sensation in his hip joint during a game. Although an osteosarcoma was suspected clinically and radiographically, a Tru-Cut needle biopsy of the lesion revealed reactive bone formation. Correlation of the clinical, radiographic, and pathologic findings indicated an avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissues. The healing phase of an avulsion fracture may clinically and radiographically be mistaken for neoplasia. In such cases, a Tru-Cut needle biopsy may reveal the reactive nature of the process.

Adolescent↗
PubMedDate not supplied

Endometrial ossification and infertility: the diagnostic value of different imaging techniques.

We present a case of longstanding secondary subfertility caused by endometrial ossification. Of all diagnostic techniques performed, magnetic resonance imaging and hysterosalpingography did not detect the abnormality. Transvaginal ultrasound and computed tomography clearly showed the endometrial pathology. After successful operative hysteroscopy with removal of the osseous tissue, the patient became pregnant spontaneously within 2 months.

Adult↗
PubMed1999

Tetraparesis associated with ossification of the posterior longitudinal ligament of the cervical spine.

This is a case report of tetraparesis associated with extraordinarily severe ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. There was no history of trauma. The object of this paper is to show that OPLL can progress relentlessly to a nearly complete quadriplegia even without trauma, but that adequate decompression can produce almost complete recovery.

Cervical Vertebrae↗
PubMed2001

Heterotopic ossification following internal fixation or arthroplasty for displaced femoral neck fractures: a prospective randomized study.

One hundred hips in 99 patients of 75 years or older, with a displaced femoral neck fracture, were studied for heterotopic ossification (HO). The patients were randomized to either internal fixation or total hip arthroplasty (THA). In the THA group HO was found in 32 of 45 hips compared with 1 of 39 in the internal fixation group (P < 0.0012). The frequency of HO after THA corresponds well with findings in other studies on patients receiving THA for osteoarthrosis. In cervical fractures the surgical procedure of total hip replacement seems to be a prerequisite for HO, indicating that the procedure itself is more important than the patient's age and the diagnosis. Severe symptoms due to HO were found in only one patient. HO following THA for a femoral neck fracture is of little clinical importance and prophylaxis is unnecessary.

Age Distribution↗
PubMed2005

Magnetic resonance signal alterations in the acute onset of heterotopic ossification in patients with spinal cord injury.

The purpose of our study was to evaluate magnetic resonance (MR) signal characteristics of acutely forming heterotopic ossification (HO) in paralyzed patients. Fourteen patients with spinal cord injury (female n=2, male n=12, mean age 38.3 years) and acute onset of radiographically proven HO had contrast-enhanced 1.5-T MRI within 13.4+/-18.3 days of clinical onset of symptoms. MR signal alterations of affected muscles, fascia, subcutaneous tissue, skin and adjacent bone were evaluated. A diffuse T2-hyperintense signal of multiple muscle groups was seen in all patients (bilateral in 12) involving quadriceps (n=13, 93%), adductors (n=13, 93%) and iliopsoas (n=12, 86%) with contrast enhancement in n=11 (79%), n=8 (57%) and n=8 (57%) patients. All patients had nonenhancing areas (mean size 2 x 3.5 x 5.8 cm) within diffusely enhancing muscles. HO formation occurred around these nonenhancing areas in four patients with computed tomography follow-up. Other MR findings included fascial edema (n=14, 100%), fascial enhancement (n=13, 93%), subcutaneous edema (n=13, 93%), subcutaneous enhancement (n=12, 86%), bone marrow edema (n=5, 36%), and joint effusion (n=12, 86%). MRI reveals mostly bilateral edema and enhancement of muscles, fascia and subcutaneous tissue during acute onset of HO. HO develops in the periphery of well-defined areas of no enhancement.

Adolescent↗
PubMed2001

Preoperative arterial embolization in heterotopic ossification: a case report.

We report a case of preoperative embolization in a 64-year-old patient suffering from total stiffness of the right hip joint due to heterotopic ossification following brain injury and pertrochanteric fracture of the right femur. A previous attempt of operative treatment could not be performed successfully due to bleeding complications. After the embolization of the correlating hypervascularisation, the surgical procedure was redone and finished with good result and minimal bleeding complications during the operation and a tolerable drop of the haemoglobin concentration postoperatively.

Angiography↗
PubMed2004

Dose-dependent efficacy of diclofenac-cholestyramine on pain and periarticular ossifications after total hip arthroplasty: a double-blind, prospective, randomised trial.

INTRODUCTION: To investigate the efficacy of treatment with diclofenac-cholestyramine on postoperative pain and functional outcome after total hip arthroplasty, a randomised double-blind study was conducted. MATERIALS AND METHODS: A total of 245 patients received postoperative treatment with 75 mg or 150 mg diclofenac p.o. daily for 14 days. RESULTS: Patients who received 75 mg diclofenac per day needed paracetamol as an additional analgesic significantly more often (p=0.0162) than patients who were treated with 150 mg diclofenac daily (75 mg twice a day). The incidence of adverse gastrointestinal events was significantly lower in the group receiving 75 mg diclofenac daily than in the group receiving the higher dose (23.1% vs 37.1%; p=0.025). Six months after the operation, no differences were observed between the two groups with regard to pain or functionality measured in terms of overall mobility of the hip. No patient of either group developed clinically relevant heterotopic ossifications. CONCLUSION: Treatment with a dose of 75 mg diclofenac once daily-if necessary with the additional use of paracetamol-is a favourable option for the postoperative care of THA.

Acetaminophen↗
PubMed2005

Limited range of motion caused by heterotopic ossifications in primary total knee arthroplasty: a retrospective study of 27/191 cases.

INTRODUCTION: Heterotopic ossification (HO) following primary total knee arthroplasty is a rare complication and may be symptomatic if massive enough. Especially the range of motion (ROM) is essential for the function and durability of the implant. The aim of the study was to evaluate the influence of HO on ROM using clinical and radiological parameters. MATERIALS AND METHODS: We reviewed 191 primary total knee arthroplasties according to the clinical preoperative and postoperative parameters of the Knee Society Score with special interest paid to the ROM. Standardized radiographs were taken at three levels and the implant position compared. The patients were divided into group 1 (with HO) and group 2 (without HO). The clinical and radiological parameters were compared. RESULTS: We found an incidence of HO in 14.1% (n = 27). Group 1 showed a decreased ROM postoperatively (p = 0.003) and worse flexion contracture (p = 0.04) compared with group 2. The evaluated radiological parameters showed no significant difference between the two groups. CONCLUSION: We found a significant limitation of ROM because of HO in our study. We found no correlation between HO and component alignment or component position. Local irritation has to be considered the main reason for limited ROM.

Adult↗