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At least 1,279 records · Page 71Linked to original sources
PubMed1992

Endochondral ossification and de novo collagen synthesis during repair of the rat Achilles tendon.

Ectopic endochondral ossification is the inevitable consequence of midpoint tenotomy of the rat Achilles tendon. After tenotomy, the tendon stumps retract and the intervening space fills with granulation tissue. The initiation of chondrogenesis is indicated by pre-chondrocytic cells forming a "whorled" pattern, both at the tendon stumps and within the granulation tissue and later clearly differentiating into cartilage nodules. The chondrocytes rapidly "hypertrophy" exhibiting an orientation similar to that in epiphyseal growth plates. The nodules of cartilage are then replaced, by bone. During this total process, a temporal and spatial pattern of new collagen synthesis can be demonstrated, both biochemically and immunocytochemically. Both the cartilage and the subsequent bone closely resemble the tissue in developing long bones enabling this model to be used to study the initial switching on of normal chondrogenesis and osteogenesis in a system not normally programmed to do so.

Achilles Tendon↗
PubMed1999

Radiation therapy for heterotopic ossification.

Heterotopic ossification is a common complication after bone and joint surgery. If the disease progresses, it may cause pain and disability, eventually defeating the purpose of surgery in the first place. Today, prophylactic treatment is indicated after surgery. Both nonsteroidal antiinflammatory drugs and radiation therapy are effective. Radiation therapy is associated with fewer side effects and is preferred. Single-dose postoperative irradiation has been found to be as effective as fractionated radiation therapy.

Humans↗
PubMed1998

Ossification of the human stylohyoid ligament: a longitudinal study.

We report the results of a longitudinal radiographic study of ossification of the stylohyoid ligament in a sample of patients treated for minor malocclusions. The results suggest that the vast majority of ossified sites in the stylohyoid ligaments are established during childhood and adolescence. The mean length of the sites shows a fairly rapid, linear increase with age until the end of adolescence; any further increase is nonlinear and occurs at a much slower rate. In young individuals the ossified sites were predominant in the superior part of the ligament. With increasing age ossified sites became prevalent also in other parts of the ligament. Ossified sites in the inferior part close to the hyoid bone were more common than previously reported.

Adolescent↗
PubMed2002

Thoracic spinal cord compression by ligamentum flavum ossifications.

Ossification of the ligamentum flavum is common in Japan but rare in Western countries. Myelopathy of variable severity is a possible complication. Extension of the lesions over several levels at the thoracic spine is exceedingly rare. We report a new case in a 50-year-old man who had slowly progressive spinal cord compression with a sensory level at the navel. Computed tomography (CT) and magnetic resonance imaging (MRI) of the thoracic spine showed calcium-density masses that were in contact with the neural arches and bulged into the spinal canal at T5/T6, T7/T8, T9/T10, and T10/T11. Laboratory test findings were unremarkable. Surgical decompression by laminectomy and foraminotomy was followed by a favorable outcome. Histology showed extensive areas of bone metaplasia associated with calcific deposits. The diagnosis, treatment, and possible etiologies of this rare condition are discussed based on a literature review.

Humans↗
PubMed2003

Uniaxial cyclic stretch induces osteogenic differentiation and synthesis of bone morphogenetic proteins of spinal ligament cells derived from patients with ossification of the posterior longitudinal ligaments.

Ossification of the posterior longitudinal ligament of the spine (OPLL) is characterized by ectopic bone formation in the spinal ligaments. Mechanical stress, which acts on the posterior ligaments, is thought to be an important factor in the progression of OPLL. To elucidate this mechanism, we investigated the effects of in vitro sinusoidal cyclic stretch (120% peak to peak, at 1 Hz) on cultured spinal ligament cells derived from OPLL and non-OPLL patients. The mRNA expressions of alkaline phosphatase (ALP), osteopontin, bone morphogenetic protein (BMP)-2, BMP-4, and BMP receptors as well as ALP activity in cell layers and production of BMPs into the conditioned medium were significantly increased by cyclic stretch in OPLL cells, whereas no change was observed in non-OPLL cells. A stretch-activated Ca(2+) channel blocker, Gd(3+), the voltage-dependent L-type Ca(2+) channel blockers diltiazem and nifedipine, and Ca(2+)-free medium suppressed stretch-induced ALP activity, which suggests a role of Ca(2+) influx in the signal transduction of mechanical stress to the osteogenic response of OPLL cells. Our study provides first evidences that mechanical stress plays a key role in the progression of OPLL through the induction of osteogenic differentiation in spinal ligament cells and the promotion of the autocrine/paracrine mechanism of BMPs in this lesion.

Alkaline Phosphatase↗
PubMed1991

Stapedius tendon ossification: a rare cause of congenital conductive hearing loss.

Two cases are presented of bilateral conductive deafness in siblings. An initial presumptive diagnosis of otosclerosis was made in the first case, that of a nine-year-old girl with a bilateral hearing loss of 45 dB. Exploratory tympanotomy revealed normal ossicles but the stapedius 'tendon' was found to be a solid bony bar fixing the stapes. Division of the 'tendon' resulted in normal ossicular mobility and return of hearing with closure of the air-bone gap. Identical ossification was found in her other ear, and some years later in both ears of one of her brothers. Similar surgery restored hearing successfully in each case. An acquired aetiology has been proposed in one of the three previously reported cases; this report, however, suggests the congenital nature of the anomaly. No previous cases have been described occurring in siblings.

Adult↗
PubMed1993

Tympanic membrane ossification.

Ossification of the tympanic membrane after myringoplasty is recorded for the first time. Myringoplasty was performed for closure of a perforation which followed the surgical treatment of otitis media with effusion and had included the insertion of a long-term T-tube.

Audiometry, Pure-Tone↗
PubMed2006

Cricoid ossification mimicking an impacted foreign body.

A 54-year-old man complained of severe throat pain and showed subglottic oedema on fibre-optic endoscopy with a distinctly narrowed subglottic space on anteroposterior radiography of the neck and dense linear opacity at the level of the cricoid cartilage on lateral plain radiography. These findings suggested a foreign body just posterior to the cricopharyngeus, but a computed tomography (CT) scan demonstrated a dense calcified ridge on the posterior lamina of the cricoid cartilage but no foreign body.The patient improved symptomatically with systemic antibiotics and topical steroids, and gastrointestinal endoscopy did not detect any foreign body. This is a rare case of vertical ossification of the cricoid lamina masquerading as a foreign body.

Cricoid Cartilage↗
PubMed2003

Prevention of heterotopic ossification after total hip replacement with NSAIDs.

INTRODUCTION: Non steroidal anti-inflammatory drugs (NSAIDs) and prophylactic radiotherapy can prevent ectopic bone formation around the hip after total hip arthroplasty. METHODS: We retrieved from Medline, Embase and the Cochrane Register (clinical) trials and other relevant literature on the prevention of heterotopic ossification (HO) from 1990-2002 for further review. RESULTS: Review of these clinical trials shows that HO is effectively prevented by a postoperative NSAID treatment with indomethacin for at least seven days. The best evidence is available for indomethacin, although naproxen, diclofenac and ibuprofen are also well documented. Short term use of ibuprofen is not effective. If NSAIDs are contraindicated, preoperative or postoperative radiotherapy is a very effective therapeutic option to prevent HO. DISCUSSION AND CONCLUSION: Because of the potential of serious gastrointestinal side effects of NSAIDs and their interaction with anticoagulant drugs, rofecoxib and other COX-2 specific NSAIDs may be a safer option for the treatment of HO. However, randomised controlled studies are needed to confirm the results of the rofecoxib study.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1990

Serum alkaline phosphatase and inorganic phosphorus values in spinal cord injury patients with heterotopic ossification.

The blood chemistry was studied in 140 spinal cord injury (SCI) patients (acute injury ward), including 18 patients who developed heterotopic ossification (HO). Comparisons between the HO and non-HO groups were made to determine if the alkaline phosphatase (AP), inorganic phosphorus (P), or calcium (Ca) levels were of diagnostic value. The results showed that AP, P, and Ca by themselves were of little help in the diagnosis of HO. However, the combination of elevated AP and P was significant, especially if both were consistently elevated. There were no significant differences between the HO and non-HO groups concerning completeness or level of spinal injury.

Adult↗
PubMed1992

Computerized quantitative radionuclide assessment of heterotopic ossification in spinal cord injury patients.

We evaluated the progression of heterotopic ossification (HO) in 17 spinal cord injury patients by comparing radiographs, quantitative radionuclide bone scans, and serum alkaline phosphatase levels. Evidence of maturation of HO appeared earlier (3 months to 6 years post injury) in radiographs, whereas, during the same time frame, radioactive nuclide assessment showed continued progression of HO in 10 out of the 17 patients. The evolution of HO appeared to take place over a period ranging between 3 and 80 months. We believe that stabilization of HO may be reasonably defined in terms of uptake ratios of 2.0 or less in patients with initial uptake ratios over 3.0 but below 5.0, and of ratios of 3.0 or less when the initial values are over 5.0.

Adult↗
PubMed1992

Ossification of the posterior longitudinal ligament in the thoracic spine causing intermittent paraplegia in an Englishman: case report.

Compression of the spinal cord due to ossification of the posterior longitudinal ligament (OPLL) often leads to quadriplegia or paraplegia in Japanese patients. This disease is uncommon in other races. We report the case of a middle-aged Englishman who presented with complaints of intermittent paraparesis due to OPLL at the T5-T6 level in his thoracic spine.

Humans↗
PubMed1993

Ultrasound in the early diagnosis of heterotopic ossification in patients with spinal injuries.

Heterotopic ossification (HO) is a potentially disabling complication of spinal injuries and other chronic disorders. It is of unknown aetiology and currently there is no easy or convenient diagnostic method that will allow very early confirmation of the inflammatory changes that precede osteoid and, later, true bone formation. Clinical experience, however, indicates that early treatment with radiotherapy, antiinflammatory agents or diphosphonates is needed to control the progression. This study was undertaken to assess the role of ultrasound (US) in the very early diagnosis of HO in patients with spinal injuries. US was found to be very sensitive in detecting focal soft tissue abnormalities around joints and in the muscles of these patients. If combined with a Doppler study to exclude deep venous thrombosis (DVT), and infection or tumour could be excluded clinically, US was extremely accurate in predicting the presence or absence of early HO changes within hours of the clinical manifestation. In 2 patients it successfully predicted HO in the opposite leg before clinical signs were evident. This study also provided supportive evidence of the theory of microtrauma in the aetiology of HO. As ultrasound is portable, safe, cheap, reproducible and accurate, it is the method of choice in the early diagnosis of HO. It allows early treatment to prevent the formation of osteoid and subsequent bone formation.

Adult↗
PubMed1993

The association between deep venous thrombosis and heterotopic ossification in patients with acute traumatic spinal cord injury.

The medical records of 209 patients with acute traumatic spinal cord injury (SCI) admitted to the SCI rehabilitation unit from 7/1/88 through 12/31/92 were reviewed. Whereas the incidence of heterotopic ossification (HO) and deep venous thrombosis (DVT) in this population were 16.7% and 14.3%, respectively, 36.6% of the individuals with DVT had HO. 31.4% of those with HO developed DVT at some time during their acute or rehabilitation hospitalization. The overall incidence of coexistent DVT and HO was 5.3%. The correlation between the occurrence of HO and DVT in this SCI population reached statistical significance (chi 2 = 9.97; p < 0.005). The results of this study suggest that there exists an association between the occurrence of DVT and HO following traumatic SCI. We hypothesize that venous compression from expanding heterotopic bone can result in lower limb DVT following traumatic SCI.

Acute Disease↗
PubMed1995

Cervical laminoplasty in patients with ossification of the posterior longitudinal ligaments.

Cervical laminoplasty was the operation used for myeloradiculopathy secondary to ossification of the posterior longitudinal ligaments. Some 57 patients were followed up for 5-13 years (average: 7.8 years). The spinal canal from C3 to C7 was surgically opened en bloc unilaterally with spacer bone grafting to maintain the laminae in a 'kept open' position and thus to implement posterior decompression. No serious major surgery-related complications were observed. Favourable results were obtained in 42 patients (74%), but those with advanced preoperative neurological symptoms did not improve. Patients with spinal canals seriously compromised by anterior ossified lesions recovered poorly. We concluded that laminoplasty is recommended for cervical myeloradiculopathy due to ossified posterior longitudinal ligaments for selected patients, but surgery should be done before the patient has developed serious neurological damage.

Aged↗
PubMed1995

Influence of minor trauma to the neck on the neurological outcome in patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine.

The influence of minor trauma to the neck on the neurological outcome in patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine was evaluated retrospectively. Out of 118 patients treated in our clinic for cervical OPLL between 1976 and 1992, 27 had sustained minor trauma to the cervical spine. Of these 27 patients, 13 developed myelopathy, seven showed deterioration of preexisting myelopathy, and no neurological change was observed in seven patients. Regarding the relationship between the diameter of the residual spinal canal and the neurological outcome in these 27 patients, 18 out of the 19 patients with a narrow residual spinal canal (< 10 mm) developed neurological deterioration, whereas that occurred in only two of the eight patients with a wider spinal canal (> or = 10 mm). Although the severity of myelopathy and the transverse area of the spinal cord measured from T1-weighted magnetic resonance images, in patients who had sustained minor trauma was not statistically different from patients without trauma, neurological recovery after surgical treatment was poorer in the former group than in the latter. These results indicate that even indirect minor trauma to the neck can cause irreversible changes in the spinal cord if there is marked stenosis of the cervical spinal canal; such patients who are at risk, must be educated, and should be told to avoid even minor injuries at any cost.

Adult↗