Spinal fractures in patients with Diffuse idiopathic skeletal hyperostosis:A nationwide multi-institution survey

Diffuse idiopathic skeletal hyperostosis (DISH) increases the spine's susceptibility to unstable fractures that can cause neurological deterioration. However, the detail of injury is still unclear. A nationwide multicenter retrospective study was conducted to assess the clinical characteristics...

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Bibliographic Details
Published in:Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2019-07, Vol.24 (4), p.601-606
Main Authors: Okada, Eijiro, Yoshii, Toshitaka, Yamada, Tsuyoshi, Watanabe, Kei, Katsumi, Keiichi, Hiyama, Akihiko, Watanabe, Masahiko, Nakagawa, Yukihiro, Okada, Motohiro, Endo, Teruaki, Shiraishi, Yasuyuki, Takeuchi, Kazuhiro, Matsunaga, Shunji, Maruo, Keishi, Sakai, Kenichiro, Kobayashi, Sho, Ohba, Tetsuro, Wada, Kanichiro, Ohya, Junichi, Mori, Kanji, Tsushima, Mikito, Nishimura, Hirosuke, Tsuji, Takashi, Okawa, Atsushi, Matsumoto, Morio, Watanabe, Kota
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Female
Fracture Fixation
Humans
Hyperostosis, Diffuse Idiopathic Skeletal - complications
Hyperostosis, Diffuse Idiopathic Skeletal - diagnostic imaging
Hyperostosis, Diffuse Idiopathic Skeletal - surgery
Male
Middle Aged
Radiography
Retrospective Studies
Risk Factors
Spinal Fractures - diagnostic imaging
Spinal Fractures - etiology
Spinal Fractures - surgery
Spinal Fusion
Surveys and Questionnaires
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Summary:Diffuse idiopathic skeletal hyperostosis (DISH) increases the spine's susceptibility to unstable fractures that can cause neurological deterioration. However, the detail of injury is still unclear. A nationwide multicenter retrospective study was conducted to assess the clinical characteristics and radiographic features of spinal fractures in patients with DISH. Patients were eligible for this study if they 1) had DISH, defined as flowing ossification along the anterolateral aspect of at least four contiguous vertebral bodies, and 2) had an injury in the ankylosing spine. This study included 285 patients with DISH (221 males, 64 females; mean age 75.2 ± 9.5 years). The major cause of injury was falling from a standing or sitting position; this affected 146 patients (51.2%). Diagnosis of the fracture was delayed in 115 patients (40.4%). Later neurological deterioration by one or more Frankel grade was seen in 87 patients (30.5%). The following factors were significantly associated with neurological deficits: delayed diagnosis (p = 0.033), injury of the posterior column (p = 0.021), and the presence of ossification of the posterior longitudinal ligament (OPLL) (p 
ISSN:0949-2658
1436-2023
DOI:10.1016/j.jos.2018.12.017