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[PMID]:28385821
[Au] Autor:Nouri A; Fehlings MG
[Ad] Endereço:Spinal Cord Injury Clinical Research Unit (Nouri), Toronto Western Hospital, University Health Network; Division of Neurosurgery, Department of Surgery, and Spinal Program (Fehlings), University of Toronto, Toronto, Ont.
[Ti] Título:Diffuse idiopathic skeletal hyperostosis with cervical myelopathy.
[So] Source:CMAJ;189(10):E410, 2017 03 13.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Vértebras Cervicais/diagnóstico por imagem
Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem
Ossificação do Ligamento Longitudinal Posterior/diagnóstico por imagem
Compressão da Medula Espinal/diagnóstico
[Mh] Termos MeSH secundário: Vértebras Cervicais/cirurgia
Descompressão Cirúrgica/métodos
Seres Humanos
Hiperostose Esquelética Difusa Idiopática/complicações
Hiperostose Esquelética Difusa Idiopática/cirurgia
Laminectomia/métodos
Ligamento Amarelo/diagnóstico por imagem
Ligamentos Longitudinais/diagnóstico por imagem
Masculino
Meia-Idade
Ossificação do Ligamento Longitudinal Posterior/complicações
Ossificação do Ligamento Longitudinal Posterior/cirurgia
Ossificação Heterotópica/complicações
Ossificação Heterotópica/diagnóstico por imagem
Ossificação Heterotópica/cirurgia
Compressão da Medula Espinal/etiologia
Compressão da Medula Espinal/cirurgia
Fusão Vertebral/métodos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.160487


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[PMID]:28371859
[Au] Autor:Kuperus JS; de Gendt EEA; Oner FC; de Jong PA; Buckens SCFM; van der Merwe AE; Maat GJR; Regan EA; Resnick DL; Mader R; Verlaan JJ
[Ad] Endereço:Department of Orthopaedics.
[Ti] Título:Classification criteria for diffuse idiopathic skeletal hyperostosis: a lack of consensus.
[So] Source:Rheumatology (Oxford);56(7):1123-1134, 2017 Jul 01.
[Is] ISSN:1462-0332
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: DISH is a condition characterized by flowing ossifications of the spine with or without ossifications of entheses elsewhere in the body. Studies on the prevalence and pathogenesis of DISH use a variety of partly overlapping combinations of classification criteria, making meaningful comparisons across the literature difficult. The aim of this study was to systematically summarize the available criteria to support the development of a more uniform set of diagnostic/classification criteria. Methods: A search was performed in Pubmed, Embase, Cochrane Library and Web of Science using the term DISH and its synonyms. Articles were included when two independent observers agreed that the articles proposed a new set of classification criteria for DISH. All retrieved articles were evaluated for methodological quality, and the presented criteria were extracted. Results: A total of 24 articles met the inclusion criteria. In all articles, spinal hyperostosis was required for the diagnosis of DISH. Peripheral, extraspinal manifestations were included as a (co-)requirement for the diagnosis DISH in five articles. Most discrepancies revolved around the threshold for the number of vertebral bodies affected and to defining different developmental phases of DISH. More than half of the retrieved articles described a dichotomous set of criteria and did not consider the progressive character of DISH. Conclusion: This systematic review summarizes the available different classification criteria for DISH, which highlights the lack of consensus on the diagnosis of (early) DISH. Consensus criteria, including consecutive phases of new bone formation that characterize DISH, can be developed based upon established diagnostic/classification criteria.
[Mh] Termos MeSH primário: Avaliação da Deficiência
Hiperostose Esquelética Difusa Idiopática/classificação
Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Consenso
Progressão da Doença
Feminino
Seres Humanos
Hiperostose Esquelética Difusa Idiopática/patologia
Masculino
Meia-Idade
Determinação de Necessidades de Cuidados de Saúde
Prognóstico
Radiografia/métodos
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1093/rheumatology/kex056


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[PMID]:28369706
[Au] Autor:Katzman WB; Huang MH; Kritz-Silverstein D; Barrett-Connor E; Kado DM
[Ad] Endereço:University of California, San Francisco, California.
[Ti] Título:Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Impaired Physical Function: The Rancho Bernardo Study.
[So] Source:J Am Geriatr Soc;65(7):1476-1481, 2017 Jul.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Investigate associations of diffuse idiopathic skeletal hyperostosis (DISH) with self-reported and measured physical function in older adults. DESIGN: Cross-sectional analyses of data collected in 1992-96 from a longitudinal cohort. SETTING: Research clinic within a community. PARTICIPANTS: Community-dwelling men (n = 630) and women (n = 961), mean age 71.5 years (SD = 10.8), from the Rancho Bernardo Study. MEASUREMENTS: DISH assessed from lateral thoracic and lumbar spine radiographs; self-reported difficulty bending over to the floor, walking 2-3 level blocks, or climbing 1 flight of stairs; performance-based measures of grip strength and chair-stand testing (ability to stand up and sit down in a chair 5 times without using chair arms). RESULTS: DISH was present in 25.6% of men and 5.5% of women. In age and sex-adjusted models, those with DISH had 1.72-fold increased odds (95% CI: 1.13, 2.62) of self-reported difficulty bending; this remained significant after further adjustment for Cobb angle, weight, stroke, arthritis, and exercise, OR = 1.69, (95% CI: 1.07, 2.66). In fully adjusted multivariate models, those with DISH had worse grip strength, -1.08 kg, P = .01, but did not differ from those without DISH on walking or climbing stairs. In sex-stratified, fully adjusted models, among men only, those with DISH were 2.17-times (95% CI: 1.04, 4.52) more likely to be unable to complete 5 chair stands without using their arms. CONCLUSIONS: DISH was less prevalent in women but affected almost one-quarter of older white men. People with DISH are more likely to experience physical functional impairment, suggesting that DISH has clinical correlations and is not an incidental radiographic finding.
[Mh] Termos MeSH primário: Hiperostose Esquelética Difusa Idiopática/epidemiologia
Postura/fisiologia
Caminhada/fisiologia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
California/epidemiologia
Estudos Transversais
Feminino
Força da Mão
Seres Humanos
Estudos Longitudinais
Vértebras Lombares/diagnóstico por imagem
Masculino
Prevalência
Radiografia
Medição de Risco
Fatores Sexuais
Inquéritos e Questionários
Vértebras Torácicas/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.14810


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[PMID]:28363281
[Au] Autor:Takagi Y; Yamada H; Ebara H; Hayashi H; Iwanaga T; Shimozaki K; Kitano Y; Kagechika K; Tsuchiya H
[Ad] Endereço:Department of Orthopaedic Surgery, Tonami General Hospital, 1-61 Shintomi-cho, Tonami City, Toyama, 939-1395, Japan. takagi@p1.coralnet.or.jp.
[Ti] Título:Thoracic spondylolisthesis and spinal cord compression in diffuse idiopathic skeletal hyperostosis: a case report.
[So] Source:J Med Case Rep;11(1):90, 2017 Apr 01.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Diffuse idiopathic skeletal hyperostosis has long been regarded as a benign asymptomatic clinical entity with an innocuous clinical course. Neurological complications are rare in diffuse idiopathic skeletal hyperostosis. However, if they do occur, the consequences are often significant enough to warrant major neurosurgical intervention. Neurological complications occur when the pathological process of ossification in diffuse idiopathic skeletal hyperostosis extends to other vertebral ligaments, causing ossification of the posterior longitudinal ligaments and/or ossification of the ligamentum flavum. Thoracic spondylolisthesis with spinal cord compression in diffuse idiopathic skeletal hyperostosis has not previously been reported in the literature. CASE PRESENTATION: A 78-year-old Japanese man presented with a 6-month history of gait disturbance. A magnetic resonance imaging scan of his cervical and thoracic spine revealed anterior spondylolisthesis and severe cord compression at T3 to T4 and T10 to T11, as well as high signal intensity in a T2-weighted image at T10/11. Computed tomography revealed diffuse idiopathic skeletal hyperostosis at T4 to T10. He underwent partial laminectomy of T10 and posterior fusion of T9 to T12. The postoperative magnetic resonance imaging revealed resolution of the spinal cord compression and an improvement in the high signal intensity on the T2-weighted image. CONCLUSIONS: We report the first case of thoracic spondylolisthesis and spinal cord compression in diffuse idiopathic skeletal hyperostosis. Neurosurgical intervention resulted in a significant improvement of our patient's neurological symptoms.
[Mh] Termos MeSH primário: Transtornos Neurológicos da Marcha/diagnóstico por imagem
Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem
Laminectomia
Compressão da Medula Espinal/diagnóstico por imagem
Fusão Vertebral
Espondilolistese/diagnóstico por imagem
Vértebras Torácicas/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Transtornos Neurológicos da Marcha/etiologia
Transtornos Neurológicos da Marcha/fisiopatologia
Seres Humanos
Hiperostose Esquelética Difusa Idiopática/complicações
Hiperostose Esquelética Difusa Idiopática/fisiopatologia
Imagem por Ressonância Magnética
Masculino
Compressão da Medula Espinal/fisiopatologia
Compressão da Medula Espinal/cirurgia
Espondilolistese/fisiopatologia
Espondilolistese/cirurgia
Vértebras Torácicas/patologia
Vértebras Torácicas/cirurgia
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170402
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1252-0


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[PMID]:28314808
[Au] Autor:Candelario N; Lo KB; Naranjo M
[Ad] Endereço:Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
[Ti] Título:Cervical diffuse idiopathic skeletal hyperostosis (DISH) causing oropharyngeal dysphagia.
[So] Source:BMJ Case Rep;2017, 2017 Mar 17.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory condition characterised by calcification and ossification of the vertebral ligaments. It is most commonly seen to affect the thoracic and lumbar vertebrae and is usually seen among elderly men. The cause of this condition is unknown. Risk factors include male gender, obesity, diabetes and advancing age. The majority of these cases are found incidentally on imaging and patients are generally asymptomatic. Cervical DISH is less common than its thoracic and lumbar counterparts. When symptomatic, it can cause dysphagia or sometimes airway compromise. If this happens, surgical intervention should be performed. Although a rare cause of dysphagia, DISH is easily diagnosed with imaging. When identified, surgical decompression produces very good clinical outcomes.
[Mh] Termos MeSH primário: Transtornos de Deglutição/etiologia
Hiperostose Esquelética Difusa Idiopática/complicações
[Mh] Termos MeSH secundário: Idoso
Vértebras Cervicais/diagnóstico por imagem
Transtornos de Deglutição/diagnóstico por imagem
Seres Humanos
Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem
Hiperostose Esquelética Difusa Idiopática/cirurgia
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170516
[Lr] Data última revisão:
170516
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170319
[St] Status:MEDLINE


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[PMID]:28224297
[Au] Autor:Lindtner RA; Kammerlander C; Goetzen M; Keiler A; Malekzadeh D; Krappinger D; Schmid R
[Ad] Endereço:Department of Trauma Surgery, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
[Ti] Título:Fracture reduction by postoperative mobilisation for the treatment of hyperextension injuries of the thoracolumbar spine in patients with ankylosing spinal disorders.
[So] Source:Arch Orthop Trauma Surg;137(4):531-541, 2017 Apr.
[Is] ISSN:1434-3916
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The aim of this study was to evaluate results of surgical stabilisation of hyperextension injuries of the thoracolumbar spine in patients with ankylosing spinal disorders using two different treatment strategies: the conventional open rigid posterior instrumentation and percutaneous less rigid posterior instrumentation. Surgical and non-surgical complications, the postoperative radiological course, and clinical outcome at final follow-up were comparatively assessed. Moreover, we sought to discuss important biomechanical and surgical aspects specific to posterior instrumentation of the ankylosed thoracolumbar spine as well as to elaborate on the advantages and limitations of the proposed new treatment strategy involving percutaneous less rigid stabilisation and fracture reduction by postoperative mobilisation. MATERIALS AND METHODS: Between January 2006 and June 2012, a consecutive series of 20 patients were included in the study. Posterior instrumentation was performed either using an open approach with rigid 6.0 mm bars (open rigid (OR) group) or via a percutaneous approach using softer 5.5 mm bars (percutaneous less rigid (PLR) group). Complications as well as the radiological course were retrospectively assessed, and patient outcome was evaluated at final follow-up using validated outcome scores (VAS Spine Score, ODI, RMDQ, Parker Mobility Score, Barthel Score and WHOQOL-BREF). RESULTS: Surgical complications occurred more frequently in the OR group requiring revision surgery in two patients, while there was no revision surgery in the PLR group. The rate of postoperative complications was lower in the PLR group as well (0.7 vs. 1.3 complications per patient, respectively). Fracture reduction and restoration of pre-injury sagittal alignment by postoperative mobilisation occurred within the first 3 weeks in the PLR group, and within 6 months in the OR group. The clinical outcome at final follow-up was very good in both groups with no relevant loss in VAS Spine Score (pain and function), Parker Mobility Score (mobility), and Barthel Index (social independency) compared to pre-operative values. CONCLUSIONS: This study indicates that the proposed treatment concept involving percutaneous less rigid posterior instrumentation and fracture reduction by postoperative mobilisation is feasible, seems to facilitate adequate reduction and restoration of pre-injury sagittal alignment, and might have the potential to reduce the rate of complications in the management of hyperextension injuries of the ankylosed thoracolumbar spine.
[Mh] Termos MeSH primário: Fixação de Fratura/métodos
Vértebras Lombares/cirurgia
Cuidados Pós-Operatórios/métodos
Fraturas da Coluna Vertebral/cirurgia
Vértebras Torácicas/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Dor nas Costas
Feminino
Seres Humanos
Hiperostose Esquelética Difusa Idiopática/complicações
Vértebras Lombares/diagnóstico por imagem
Masculino
Meia-Idade
Medição da Dor
Modalidades de Fisioterapia
Complicações Pós-Operatórias/epidemiologia
Radiografia
Estudos Retrospectivos
Fraturas da Coluna Vertebral/complicações
Fraturas da Coluna Vertebral/diagnóstico por imagem
Traumatismos da Coluna Vertebral/complicações
Traumatismos da Coluna Vertebral/diagnóstico por imagem
Traumatismos da Coluna Vertebral/cirurgia
Espondilite Anquilosante/complicações
Vértebras Torácicas/diagnóstico por imagem
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1007/s00402-017-2653-7


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[PMID]:28125786
[Au] Autor:Leibushor N; Slonimsky E; Aharoni D; Lidar M; Eshed I
[Ad] Endereço:1 Rheumatology Unit, Sheba Medical Center, Tel Hashomer, affiliated to the Sackler School of Medicine, Tel Aviv, Israel.
[Ti] Título:CT Abnormalities in the Sacroiliac Joints of Patients With Diffuse Idiopathic Skeletal Hyperostosis.
[So] Source:AJR Am J Roentgenol;208(4):834-837, 2017 Apr.
[Is] ISSN:1546-3141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The purpose of this study is to characterize sacroiliac joints (SIJs) findings at CT of patients with diffuse idiopathic skeletal hyperostosis (DISH), a condition characterized (using the Resnick classification criteria) by ossification of at least four contiguous vertebrae in the thoracic spine and preserved disk space, but without radiographic evidence of intraarticular SIJ abnormalities. MATERIALS AND METHODS: Pelvic CT examinations of 104 patients with DISH (fulfilling the Resnick criteria on spinal CT) and 106 age- and sex-matched control subjects whose entire spine lacked CT evidence of DISH (total, 149 men and 61 women; mean [± SD] age, 72.3 ± 8.7 years) were retrospectively evaluated for the presence of intra- and extraarticular bridging osteophytes, spurs, subchondral cystlike changes, erosions, and sclerosis of SIJs. Excluded were patients with known ankylosing spondylitis or inflammatory-related diseases. Data were analyzed using multivariate ANOVA to examine the degree of difference between patients with DISH and control subjects. Logistic regression analysis was used to generate odds ratios to examine their discriminatory ability. ROC analysis was then applied to examine the sensitivity and specificity of the results. RESULTS: The frequency of anterior bridging, posterior bridging, entheseal bridging, and joint ankylosis was significantly higher among patients with DISH compared with control subjects (48% vs 9%, 20% vs 1%, 34% vs 4%, and 23% vs 0%, respectively; p < 0.001 for all comparisons). CONCLUSION: Intraarticular ankylosis seen at CT, an entity not included in the Resnick classification criteria, is common among patients with DISH, which implies that the radiologic classification criteria for DISH need to be revised.
[Mh] Termos MeSH primário: Hiperostose Esquelética Difusa Idiopática/complicações
Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem
Articulação Sacroilíaca/diagnóstico por imagem
Espondilose/diagnóstico por imagem
Espondilose/etiologia
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170410
[Lr] Data última revisão:
170410
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170127
[St] Status:MEDLINE
[do] DOI:10.2214/AJR.16.16994


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[PMID]:27749216
[Au] Autor:Giuffra V; Minozzi S; Vitiello A; Fornaciari A
[Ad] Endereço:Dept.of Translational Research and New Technologies in Medicine and Surgery, University of Pisa; and Centre for Anthropological, Paleopathological and Historical Studies, Dept.of Biomedical Sciences, Univ.of Sassari, Italy. v.giuffra@med.unipi.it.
[Ti] Título:On the history of gout: paleopathological evidence from the Medici family of Florence.
[So] Source:Clin Exp Rheumatol;35(2):321-326, 2017 Mar-Apr.
[Is] ISSN:0392-856X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Throughout history, gout has been referred to as the "disease of the kings", and has been clearly associated with the lifestyle of the aristocratic social classes. According to the written sources, several members of the famous Medici family of Florence suffered from an arthritic disease that contemporary physicians called "gout". A paleopathological study carried out on the skeletal remains of some members of the family, exhumed from their tombs in the Church of San Lorenzo in Florence, offered a unique opportunity to directly investigate the evidence of the arthritic diseases affecting this elite group. METHODS: The skeletal remains of several members of the family were examined macroscopically and submitted to x-ray investigation. RESULTS: The results of the study allowed us to ascertain that the so-called "gout of the Medici" should be considered the clinical manifestation of three different joint conditions: diffuse idiopathic skeletal hyperostosis, rheumatoid arthritis and uratic gout. In particular, uric acid gout was diagnosed in the Grand Duke Ferdinand I (1549-1609). Recently, a new case of this disease was diagnosed in Anton Francesco Maria (1618-1659), a probable illegitimate member of the family. CONCLUSIONS: With this new case, uratic gout was observed in 2 out of 9 adult males, leading to suppose that the disease should have been a common health problem within the family. The aetiology of the disease has to be searched in environmental factors, since both historical and paleonutritional studies demonstrated that the diet of this aristocratic court was rich in meat and wine.
[Mh] Termos MeSH primário: Dieta/história
Gota/história
Articulações
Estilo de Vida/história
Paleopatologia
[Mh] Termos MeSH secundário: Adulto
Artrite Reumatoide/diagnóstico por imagem
Artrite Reumatoide/história
Dieta/efeitos adversos
Gota/diagnóstico por imagem
Gota/etiologia
História do Século XVI
História do Século XVII
Seres Humanos
Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem
Hiperostose Esquelética Difusa Idiopática/história
Itália
Articulações/diagnóstico por imagem
Masculino
Paleopatologia/métodos
Linhagem
Fatores de Risco
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161018
[St] Status:MEDLINE


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[PMID]:27723250
[Au] Autor:Katzman WB; Parimi N; Mansoori Z; Nardo L; Kado DM; Cawthon PM; Marshall LM; Schousboe JT; Lane NE; Osteoporotic Fractures in Men Study Research Group and the Study of Osteoporotic Fractures
[Ad] Endereço:University of California, San Francisco.
[Ti] Título:Cross-Sectional and Longitudinal Associations of Diffuse Idiopathic Skeletal Hyperostosis and Thoracic Kyphosis in Older Men and Women.
[So] Source:Arthritis Care Res (Hoboken);69(8):1245-1252, 2017 Aug.
[Is] ISSN:2151-4658
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate cross-sectional and longitudinal associations of diffuse idiopathic skeletal hyperostosis (DISH) and thoracic kyphosis in older persons. METHODS: DISH and kyphosis were assessed in 1,500 men from the Osteoporotic Fractures in Men (MrOS) study and in 1,267 women from the Study of Osteoporotic Fractures (SOF). DISH was assessed using baseline lateral spine radiographs, and Cobb angle of kyphosis was measured from baseline and followup radiographs, a mean 4.6 years later in men, and 3.7 and 15 years later in women. Linear regression was used to analyze associations of DISH with baseline Cobb angle and with percent annualized change in Cobb angle. We tested for heterogeneity among studies. RESULTS: DISH was identified in 222 participants in MrOS (15%) and in 156 participants in SOF (12%). Participants with DISH in both cohorts had higher baseline Cobb angles (P < 0.05), after adjustment for covariates. After approximately 4 years of followup, there was no significant difference in annualized percent change in Cobb angle in those with DISH compared to those without DISH (P > 0.05) for men or women. Women with DISH had less kyphosis progression over 15 years (0.25% less annualized change in Cobb) than those without DISH. CONCLUSION: Prevalent DISH is associated with greater kyphosis in older men and women, and is not significantly associated with a change in kyphosis over 4-5 years. However, in women followed over 15 years, DISH was associated with less progression of kyphosis. These results suggest that DISH influences kyphosis and may slow progression over the long term. Additional studies of DISH/kyphosis associations are warranted to understand the functional implications of this finding.
[Mh] Termos MeSH primário: Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem
Hiperostose Esquelética Difusa Idiopática/epidemiologia
Cifose/diagnóstico por imagem
Cifose/epidemiologia
Vértebras Torácicas/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Estudos Transversais
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
Distribuição Aleatória
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161011
[St] Status:MEDLINE
[do] DOI:10.1002/acr.23115


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[PMID]:27713008
[Au] Autor:Okada E; Tsuji T; Shimizu K; Kato M; Fukuda K; Kaneko S; Ogawa J; Watanabe K; Ishii K; Nakamura M; Matsumoto M
[Ad] Endereço:Dept. of Orthopaedic Surgery, Saiseikai Central Hospital, Tokyo, Japan; Keio Spine Research Group, Tokyo, Japan.
[Ti] Título:CT-based morphological analysis of spinal fractures in patients with diffuse idiopathic skeletal hyperostosis.
[So] Source:J Orthop Sci;22(1):3-9, 2017 Jan.
[Is] ISSN:1436-2023
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To clarify correlations between spinal fracture and delayed paralysis in patients with diffuse idiopathic skeletal hyperostosis (DISH) using computed tomography (CT) with multiplanar reformatting (CT-MPR). DISH increases susceptibility to unstable spinal fractures, leading to neurological deterioration. The pathomechanism of the neurological injury is unclear. METHODS: This multicenter retrospective study included 42 DISH patients (32 male; 10 female) treated for 45 spinal fractures during a 5-year period. The mean age at the time of injury was 77.1 ± 10.1 years. The cause of injury, delay in diagnosis, fracture location, and neurological status were recorded, and anterior- and posterior-column fractures, a fracture displacement over 3 mm, and posterior-column ankylosis were assessed using CT-MPR. RESULTS: Most fractures (73.8%) resulted from trivial trauma, such as falling from a standing or sitting position. Diagnosis was delayed in 47.6% of the patients, primarily due to delays in seeking medical attention (65.0%). Although 78.6% of the patients were neurologically intact at the time of injury, 54.8% developed paralysis, defined by a change in one or more Frankel-score levels during short-term follow-up. Of the fractures, 39.1% were in the vertebral body, and 60.9% were at the disc level. Fractures with posterior-column ankylosis were significantly associated with delayed paralysis. CONCLUSIONS: CT-MPR was useful for evaluating spinal fractures and determining treatment in patients with DISH. Fractures associated with posterior-column ankylosis resulted in unstable three-column injuries that led to delayed neurological deterioration. Early surgical stabilization of such fractures is recommended to avoid delayed paralysis.
[Mh] Termos MeSH primário: Fixação Interna de Fraturas/métodos
Hiperostose Esquelética Difusa Idiopática/complicações
Fraturas da Coluna Vertebral/diagnóstico por imagem
Fraturas da Coluna Vertebral/terapia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Placas Ósseas
Estudos de Coortes
Tratamento Conservador/métodos
Feminino
Fixação Interna de Fraturas/instrumentação
Consolidação da Fratura/fisiologia
Seres Humanos
Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem
Escala de Gravidade do Ferimento
Japão
Imagem por Ressonância Magnética/métodos
Masculino
Meia-Idade
Prognóstico
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Fatores Sexuais
Fraturas da Coluna Vertebral/etiologia
Vértebras Torácicas/diagnóstico por imagem
Vértebras Torácicas/lesões
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161008
[St] Status:MEDLINE



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