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UMEGAKI M, FUKUNAGA T, NINOMIYA K, MATSUMOTO K, SASAKI M. Diffuse Idiopathic Skeletal Hyperostosis with Severely Displaced Spine Fracture Managed with Posterior Approach Alone: Case Reports and Literature Review. NMC Case Rep J 2022; 9:401-405. [PMID: 36589779 PMCID: PMC9771471 DOI: 10.2176/jns-nmc.2022-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/26/2022] [Indexed: 12/03/2022] Open
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a condition in which minor trauma can cause extremely unstable vertebral fractures. Spinal fractures associated with DISH are prone to instability due to the large moment of lever arm and secondary neurological deterioration; hence, surgical internal fixation is considered necessary. On the other hand, some reports suggest that patients with DISH have a high osteogenic potential. In this report, we describe three patients with DISH. These patients had spinal injuries that resulted in a large gap, for which anterior fixation with bone graft would generally be considered due to comminuted fractures. However, we achieved good bony fusion with posterior fixation alone, without forcible correction.
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Affiliation(s)
- Masao UMEGAKI
- Department of Neurosurgery, Suita Municipal Hospital, Suita, Osaka, Japan
| | | | - Koshi NINOMIYA
- Department of Neurosurgery, Iseikai Hospital, Osaka, Osaka, Japan
| | | | - Manabu SASAKI
- Department of Neurosurgery, Hanwa Memorial Hospital, Osaka, Osaka, Japan,Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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2
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Xu L, Qian Z, Wang S, Wang R, Pu X, Yang B, Zhou Q, Du C, Chen Q, Feng Z, Xu L, Zhu Z, Qiu Y, Sun X. Galectin-3 Enhances Osteogenic Differentiation of Precursor Cells From Patients With Diffuse Idiopathic Skeletal Hyperostosis via Wnt/β-Catenin Signaling. J Bone Miner Res 2022; 37:724-739. [PMID: 35064940 DOI: 10.1002/jbmr.4508] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 11/10/2022]
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory skeletal disease characterized by the progressive ectopic ossification and calcification of ligaments and enthuses. However, specific pathogenesis remains unknown. Bone marrow mesenchymal stem cells (BMSCs) are a major source of osteoblasts and play vital roles in bone metabolism and ectopic osteogenesis. However, it is unclear whether BMSCs are involved in ectopic calcification and ossification in DISH. The current study aimed to explore the osteogenic differentiation abilities of BMSCs from DISH patients (DISH-BMSCs). Our results showed that DISH-BMSCs exhibited stronger osteogenic differentiation abilities than normal control (NC)-BMSCs. Human cytokine array kit analysis showed significantly increased secretion of Galectin-3 in DISH-BMSCs. Furthermore, Galectin-3 downregulation inhibited the increased osteogenic differentiation ability of DISH-BMSCs, whereas exogenous Galectin-3 significantly enhanced the osteogenic differentiation ability of NC-BMSCs. Notably, the increased Galectin-3 in DISH-BMSCs enhanced the expression of β-catenin as well as TCF-4, whereas attenuation of Wnt/β-catenin signaling partially alleviated Galectin-3-induced osteogenic differentiation and activity in DISH-BMSCs. In addition, our results noted that Galectin-3 interacted with β-catenin and enhanced its nuclear accumulation. Further in vivo studies showed that exogenous Galectin-3 enhanced ectopic bone formation in the Achilles tendon in trauma-induced rats by activating Wnt/β-catenin signaling. The current study indicated that enhanced osteogenic differentiation of DISH-BMSCs was mainly attributed to the increased secretion of Galectin-3 by DISH-BMSCs, which enhanced β-catenin expression and its nuclear accumulation. Our study helps illuminate the mechanisms of pathological osteogenesis and sheds light on the possible development of potential therapeutic strategies for DISH treatment. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Liang Xu
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhuang Qian
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Sinian Wang
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Rong Wang
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Xiaojiang Pu
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Bo Yang
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qingshuang Zhou
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Changzhi Du
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Quanchi Chen
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhenhua Feng
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Leilei Xu
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zezhang Zhu
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yong Qiu
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xu Sun
- Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
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Fournier DE, Beaucage KL, Beach RJ, Kiser PK, Séguin CA, Dixon SJ. Ectopic mineralisation of the mandibular symphysis in ENT1 knockout mice: A model of dystrophic calcification. Bone Rep 2021; 15:101100. [PMID: 34258331 PMCID: PMC8253951 DOI: 10.1016/j.bonr.2021.101100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023] Open
Abstract
Equilibrative nucleoside transporter 1 (ENT1) transfers nucleosides, such as adenosine, across plasma membranes. We reported previously that mice lacking ENT1 (ENT1 -/- ) exhibit progressive ectopic calcification of spinal tissues-a phenotype resembling diffuse idiopathic skeletal hyperostosis (DISH) in humans. Our objective was to investigate potential calcification of orofacial tissues in ENT1 -/- mice. Heads of wild-type mice and ENT1 -/- mice from 3 to 17 months were evaluated using microcomputed tomography (μCT). Some heads were decalcified and processed for histological assessment. Other heads were examined using energy dispersive X-ray spectroscopy and micro X-ray diffraction. Using μCT, ENT1 -/- mice showed extensive radiopaque lesions within the mandibular symphysis, the severity of which increased with advancing age. Histologically, at 6 months these ectopic radiopacities were found to correspond to acellular, amorphous, eosinophilic material, with no evidence of inflammatory cells. Because lesions were localised to the symphysis, we identified early pathological changes at 3 months and observed that lesions initiated specifically within the fibrocartilage pad. Energy-dispersive X-ray spectroscopy of ectopic lesions revealed large amounts of calcium and phosphorous in a molar ratio of ~1.59, and X-ray diffraction profiles matched that of calcium-deficient hydroxyapatite. This is the first characterisation of ectopic calcifications within the mandibular symphysis of ENT1 -/- mice, indicating a role for ENT1 and adenosine metabolism in regulating calcification of fibrocartilaginous tissues. Moreover, these murine lesions resemble areas of dystrophic calcification in the spinal tissues of humans with DISH. Importantly, ectopic calcifications develop in a reproducible temporal pattern within a well-defined anatomical region and, thus, provide a model for determining the cellular and molecular pathways underlying ectopic calcification in DISH and related disorders.
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Affiliation(s)
- Dale E Fournier
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, The University of Western Ontario, London, Ontario, Canada
| | - Kim L Beaucage
- Dentistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.,Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Ryan J Beach
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Patti K Kiser
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Cheryle A Séguin
- Bone and Joint Institute, The University of Western Ontario, London, Ontario, Canada.,Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - S Jeffrey Dixon
- Bone and Joint Institute, The University of Western Ontario, London, Ontario, Canada.,Dentistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.,Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
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Licini C, Farinelli L, Cerqueni G, Hosein A, Marchi S, Gigante A, Mattioli-Belmonte M. Heterotopic ossification in a patient with diffuse idiopathic skeletal hyperostosis: Input from histological findings. Eur J Histochem 2020; 64. [PMID: 33272008 PMCID: PMC7731577 DOI: 10.4081/ejh.2020.3176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023] Open
Abstract
A high incidence of heterotopic ossification (HO) has been reported in patients with diffuse idiopathic skeletal hyperostosis (DISH), a metabolic disease characterized by calcifications of entheses at spine and peripheral sites. We performed histological and immunohistochemical analyses in five different HO sites in a patient with DISH to study a possible mutual interaction of bone morphogenetic protein 2 (BMP-2), transforming growth factor beta (TGF-β), and decorin, crucial for bone mass increasing, matrix calcification, and endochondral bone formation. We speculated that the surgical trauma triggered HO, inducing TGF-β release at the lesion site. TGF-β recruits osteoblast precursor cells and determines the overexpression of BMP-2 in the surrounding skeletal muscle, inducing a further osteogenic differentiation, contributing to HO onset.
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Affiliation(s)
- Caterina Licini
- Department of Clinical and Molecular Sciences-DISCLIMO, Università Politecnica delle Marche, Ancona.
| | - Luca Farinelli
- Department of Clinical and Molecular Sciences-DISCLIMO, Università Politecnica delle Marche, Ancona.
| | - Giorgia Cerqueni
- Department of Clinical and Molecular Sciences-DISCLIMO, Università Politecnica delle Marche, Ancona.
| | - Andrell Hosein
- Department of Clinical and Molecular Sciences-DISCLIMO, Università Politecnica delle Marche, Ancona.
| | - Saverio Marchi
- Department of Clinical and Molecular Sciences-DISCLIMO, Università Politecnica delle Marche, Ancona.
| | - Antonio Gigante
- Department of Clinical and Molecular Sciences-DISCLIMO, Università Politecnica delle Marche, Ancona.
| | - Monica Mattioli-Belmonte
- Department of Clinical and Molecular Sciences-DISCLIMO, Università Politecnica delle Marche, Ancona.
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Kuperus JS, Mohamed Hoesein FAA, de Jong PA, Verlaan JJ. Diffuse idiopathic skeletal hyperostosis: Etiology and clinical relevance. Best Pract Res Clin Rheumatol 2020; 34:101527. [PMID: 32456997 DOI: 10.1016/j.berh.2020.101527] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic bone-forming condition characterized by the presence of at least three bony bridges at the anterolateral spine. The aim of this review was to address the present state of pathophysiological knowledge, the clinical relevance, and diagnosis of DISH. The pathogenesis of DISH is currently unknown. The presence of DISH has been associated with older age, male sex, obesity, hypertension, atherosclerosis, and diabetes mellitus. Because the new bone forms mainly at entheseal sites, local fibroblasts, chondrocytes, collagen fibers, and calcified matrix are probably influenced by genetic, vascular, metabolic, and mechanical factors. Diagnosing the presence of DISH is of clinical importance, because the risk of a spinal fracture increases and associations with the metabolic syndrome, coronary and aortic disease, and respiratory effects are strong. Unravelling the pathogenesis of DISH can impact the field of regenerative medicine and bone tissue regeneration.
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Affiliation(s)
- Jonneke S Kuperus
- Department of Orthopedics, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, the Netherlands.
| | - Firdaus A A Mohamed Hoesein
- Department of Radiology, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, the Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, the Netherlands
| | - Jorrit Jan Verlaan
- Department of Orthopedics, University Medical Center Utrecht, Postbus 85500, 3508 GA, Utrecht, the Netherlands
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May RD, Frauchiger DA, Albers CE, Tekari A, Benneker LM, Klenke FM, Hofstetter W, Gantenbein B. Application of Cytokines of the Bone Morphogenetic Protein (BMP) Family in Spinal Fusion - Effects on the Bone, Intervertebral Disc and Mesenchymal Stromal Cells. Curr Stem Cell Res Ther 2020; 14:618-643. [PMID: 31455201 PMCID: PMC7040507 DOI: 10.2174/1574888x14666190628103528] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022]
Abstract
Low back pain is a prevalent socio-economic burden and is often associated with damaged or degenerated intervertebral discs (IVDs). When conservative therapy fails, removal of the IVD (discectomy), followed by intersomatic spinal fusion, is currently the standard practice in clinics. The remaining space is filled with an intersomatic device (cage) and with bone substitutes to achieve disc height compensation and bone fusion. As a complication, in up to 30% of cases, spinal non-fusions result in a painful pseudoarthrosis. Bone morphogenetic proteins (BMPs) have been clinically applied with varied outcomes. Several members of the BMP family, such as BMP2, BMP4, BMP6, BMP7, and BMP9, are known to induce osteogenesis. Questions remain on why hyper-physiological doses of BMPs do not show beneficial effects in certain patients. In this respect, BMP antagonists secreted by mesenchymal cells, which might interfere with or block the action of BMPs, have drawn research attention as possible targets for the enhancement of spinal fusion or the prevention of non-unions. Examples of these antagonists are noggin, gremlin1 and 2, chordin, follistatin, BMP3, and twisted gastrulation. In this review, we discuss current evidence of the osteogenic effects of several members of the BMP family on osteoblasts, IVD cells, and mesenchymal stromal cells. We consider in vitro and in vivo studies performed in human, mouse, rat, and rabbit related to BMP and BMP antagonists in the last two decades. We give insights into the effects that BMP have on the ossification of the spine. Furthermore, the benefits, pitfalls, and possible safety concerns using these cytokines for the improvement of spinal fusion are discussed.
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Affiliation(s)
- Rahel Deborah May
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | | | - Christoph Emmanuel Albers
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Bern, Bern, Switzerland
| | - Adel Tekari
- Laboratory of Molecular and Cellular Screening Processes, Centre of Biotechnology of Sfax, University of Sfax, Sfax, Tunisia
| | - Lorin Michael Benneker
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Bern, Bern, Switzerland
| | - Frank Michael Klenke
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Bern, Bern, Switzerland
| | - Willy Hofstetter
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Benjamin Gantenbein
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland.,Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Bern, Bern, Switzerland
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Fournier DE, Kiser PK, Beach RJ, Dixon SJ, Séguin CA. Dystrophic calcification and heterotopic ossification in fibrocartilaginous tissues of the spine in diffuse idiopathic skeletal hyperostosis (DISH). Bone Res 2020; 8:16. [PMID: 32257530 PMCID: PMC7118090 DOI: 10.1038/s41413-020-0091-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/21/2019] [Accepted: 12/31/2019] [Indexed: 12/18/2022] Open
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a prevalent noninflammatory spondyloarthropathy characterized by ectopic mineral formation along the anterolateral aspect of the vertebral column, yet little is known about its underlying pathogenesis. Our objective was to evaluate the histopathological features and composition of ectopic mineral within spinal tissues affected by DISH in humans. Thoracic spine segments from six embalmed cadaveric donors (one female and five males; median age 82 years) meeting the radiographic diagnostic criteria for DISH were evaluated using radiological, histological, and physical analyses. Overall, the histological features of ectopic mineralization at individual motion segments were heterogeneous, including regions of heterotopic ossification and dystrophic calcification. Heterotopic ossifications were characterized by woven and lamellar bone, multifocal areas of metaplastic cartilage, and bony bridges along the anterior aspect of the intervertebral disc space. Dystrophic calcifications were characterized by an amorphous appearance, a high content of calcium and phosphorus, an X-ray diffraction pattern matching that of hydroxyapatite, and radiodensities exceeding that of cortical bone. Dystrophic calcifications were found within the anterior longitudinal ligament and annulus fibrosus in motion segments both meeting and not meeting the radiographic criteria for DISH. In summary, our findings indicate that in DISH, ectopic mineral forms along the anterior aspect of the spine by both heterotopic ossification and dystrophic calcification of fibrocartilaginous tissues. Although both types of ectopic mineralization are captured by current radiographic criteria for DISH, dystrophic calcification may reflect a distinct disease process or an early stage in the pathogenesis of DISH.
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Affiliation(s)
- Dale E. Fournier
- Health and Rehabilitation Sciences (Physical Therapy), Faculty of Health Sciences, The University of Western Ontario, London, ON N6A 5B9 Canada
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4 Canada
| | - Patti K. Kiser
- Department of Laboratory Medicine and Pathology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON N6A 5C1 Canada
| | - Ryan J. Beach
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON N6A 5C1 Canada
| | - S. Jeffrey Dixon
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4 Canada
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON N6A 5C1 Canada
| | - Cheryle A. Séguin
- Bone and Joint Institute, The University of Western Ontario, London, ON N6G 2V4 Canada
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON N6A 5C1 Canada
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Thoracic hyperextension injury with opening wedge distraction fracture in DISH -consideration of surgical strategy based on intraoperative pathological findings. J Clin Neurosci 2020; 75:231-234. [PMID: 32178994 DOI: 10.1016/j.jocn.2020.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 03/08/2020] [Indexed: 11/22/2022]
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a well-recognized disease characterized by calcifications and ossifications of the entheses mainly in the spine. Patients with DISH are prone to sustaining spinal injuries even after minor trauma because of the long-lever arm mechanism induced by any type of force acting on the rigid yet brittle spine. The number of cases of trauma in DISH-affected spines is predicted to increase during the coming decades because of an increase in DISH-related comorbidities. Generally, posterior fixation with spinal instrumentation spanning three levels above and below the injured site is regarded as a standard treatment for hyperextension fractures of the thoracolumbar spine in patients with DISH. However, no consensus has been reached regarding whether additional anterior fixation is needed for hyperextension injuries with remarkable vertebral body wedge. We experienced one case of hyperextension injury at the thoracic level in patient with DISH. A remarkable remodeling phenomenon in the fractured vertebral body was intraoperatively noticed, which was pathologically confirmed. This is the first report to have confirmed pathologically new bone formation in the anterior column wedge despite the fact that only 1 month had passed since the first injury. Although whether additional anterior fixation is needed for hyperextension injuries with remarkable vertebral body wedge is controversial, this report supports that posterior fixation alone might be an adequate treatment.
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Kuperus JS, Waalwijk JF, Regan EA, van der Horst-Bruinsma IE, Oner FC, de Jong PA, Verlaan JJ. Simultaneous occurrence of ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis: a systematic review. Rheumatology (Oxford) 2018; 57:2120-2128. [DOI: 10.1093/rheumatology/key211] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Jonneke S Kuperus
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Job F Waalwijk
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - F Cumhur Oner
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jorrit-Jan Verlaan
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
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Mader R, Verlaan JJ, Eshed I, Bruges-Armas J, Puttini PS, Atzeni F, Buskila D, Reinshtein E, Novofastovski I, Fawaz A, Kurt DV, Baraliakos X. Diffuse idiopathic skeletal hyperostosis (DISH): where we are now and where to go next. RMD Open 2017; 3:e000472. [PMID: 28955488 PMCID: PMC5604607 DOI: 10.1136/rmdopen-2017-000472] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 05/02/2017] [Accepted: 05/05/2017] [Indexed: 01/26/2023] Open
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a well-recognised entity characterised by calcifications and ossifications of the entheses affecting mainly the spine and peripheral sites. DISH is still insufficiently investigated and understood. The objective of this report is to highlight the present limitations of our understanding of the condition and suggest future research paths.
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Affiliation(s)
- Reuven Mader
- Rheumatic Diseases Unit, Ha'Emek Medical Center, Afula, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Jorrit-Jan Verlaan
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iris Eshed
- Department of Radiology, Musculoskeletal Imaging Unit, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Jacome Bruges-Armas
- Medicine, Rheumatology, SEEBMO, Hospital de Santo Espirito da ilha Terceira, Universidade do Porto, Angra do Heroísmo, Portugal.,CEDOC, Nova Medical School, University of Lisbon, Lisbon, Portugal
| | | | - Fabiola Atzeni
- Rheumatology Unit, L. Sacco University Hospital of Milan, Milan, Italy
| | - Dan Buskila
- Department of Medicine, H. Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Eyal Reinshtein
- Department of Genetics, Meir Medical Center, Kfar Saba, Israel
| | | | - Abdallah Fawaz
- Rheumatic Diseases Unit, Ha'Emek Medical Center, Afula, Israel
| | - de Vlam Kurt
- Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
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Iatridis JC, Kang J, Kandel R, Risbud MV. New horizons in spine research: Intervertebral disc repair and regeneration. J Orthop Res 2017; 35:5-7. [PMID: 28114734 PMCID: PMC5482231 DOI: 10.1002/jor.23499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- James C. Iatridis
- Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - James Kang
- Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts 02115
| | - Rita Kandel
- Department of Pathology and Laboratory Medicine, Sinai Health System, Toronto, Ontario M5G1X5, Canada
| | - Makarand V. Risbud
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
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