Journals / Ankara Üniversitesi Tıp Fakültesi Mecmuası / 2017 / Cilt: 70 - Sayı: 2

The Manifestation of Acute Developing Paraplegia: Pressure on Two Different Levels in a Patient with DISH

Akut Gelisen Parapleji Tablosu: DISH'li Bir Hastada İki Farklı Seviyede Bası

Pages
103–106
Publication Date
2022-10-10
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In this case report, acute paraplegia, which is thought to occur due to calcified ligamentum flavum at T9-10 level caused by spinal cord pressure in a patient with DISH without trauma and spontaneous L1-2 seqestration as cause of pressure of cauda equina fibers, was aimed to be presented in the light of literature information.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Diffuse Idiopathic Skeletal Hyperostosis (DISH) is an idiopathic chronic disease characterized by ossification in the ligament and tendon adhesion regions which are more common in men and after fifth decade.
📊
Key Findings & Data:Neurological tables attached to DISH are very rare, including spinal canal stenosis and myelopathy.
💡
Conclusion & Impact:In this case report, acute paraplegia, which is thought to occur due to calcified ligamentum flavum at T9-10 level caused by spinal cord pressure in a patient with DISH without trauma and spontaneous L1-2 seqestration as cause of pressure of cauda equina fibers, was aimed to be presented in the light of literature information.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Diffuse Idiopathic Skeletal Hyperostosis (DISH) is an idiopathic chronic disease characterized by ossification in the ligament and tendon adhesion regions which are more common in men and after fifth decade. Neurological tables attached to DISH are very rare, including spinal canal stenosis and myelopathy. The development of thoracic myelopathy and neurological deficit attached to ligamentum flavum ossification (LFO) is rarely seen. Cauda equina syndrome may be accompanied by bilateral or unilateral leg pain with severe back pain, saddle-like perianal hypoesthesia or anesthesia, loss of strength as far as progressive paraplegia on the lower extremity, loss of sensation and urinary incontinence. In this case report, acute paraplegia, which is thought to occur due to calcified ligamentum flavum at T9-10 level caused by spinal cord pressure in a patient with DISH without trauma and spontaneous L1-2 seqestration as cause of pressure of cauda equina fibers, was aimed to be presented in the light of literature information.

Özet

Diffüz İdiyopatik İskelet Hiperostozu (DISH); besinci dekattan sonra ve erkeklerde daha sık görülen, idiyopatik, ligament ve tendon yapısma bölgelerinde ossifikasyon ile karakterize kronik bir hastalıktır. DISH'e bağlı nörolojik tablolar ise oldukça nadir olup spinal kanal stenozu ve miyelopatiyi içermektedir. Ligamentum flavum ossifkasyonuna (LFO) bağlı torakal miyelopati ve nörolojik defisit gelisimi, oldukça az görülmektedir. Kauda equina sendromu ciddi bel ağrısının ön planda olduğu iki veya tek taraflı bel bacak ağrısı, eyer tarzı perianal hipoestezi veya anestezi, alt ekstremitede ilerleyici paraplejiye kadar gidebilen kuvvet kaybı, duyu kaybı ve idrar inkontinansı ile birlikte olabilir. Bu olgu sunumunda travma öyküsü olmayan DISH'li bir hastada, T9-10 seviyesinde kalsifiye ligamentum flavumun yaptığı spinal kord basısı ve es zamanlı L1-2 sekestre disk herniasyonunun yol açtığı kauda equina liflerinin basısına bağlı olabileceği düsünülen akut parapleji gelisiminin literatür bilgileri esliğinde sunulması amaçlanmıstır.

🔖

Cite This Article

BAL, A., ÜNLÜ, E., CAKCI, A., GÜNDOĞDU, İ., ÜNAL, Z. K. (2022). The Manifestation of Acute Developing Paraplegia: Pressure on Two Different Levels in a Patient with DISH. Ankara Üniversitesi Tıp Fakültesi Mecmuası, Cilt: 70 - Sayı: 2, 103–106. https://ajindex.com/articles/443670

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (14)

  1. Nascimento FA, Gatto LA, Lages RO, Neto HM, Demartini Z, Koppe GL. Diffuse idiopathic skeletal hyperostosis: A review. Surg Neurol Int 2014;5(Suppl.3):S122-125
  2. Cammisa M, De Serio A, Guglielmi G. Diffuse idiopathic skeletal hyperostosis. Eur J Radiol 1998;27(Suppl.1):S7-11
  3. Kurtaran A, Özdemir S, Selçuk B, Yıldırım Ö, Değirmenci İ, Akyüz M. Servikal bölgedeki yaygın idiopatik iskelet hiperostozuna bağlı gelişen santral kord sendromu. Türk Fiz Tıp Rehab Derg 2012; 58: 326-328
  4. Avci E, Ozturk A, Baba F, YucetasS, Cakır A. Ossification of the ligamentum flavum: rare cause of the thoracic myelopathy. J Neurol Sci [Turk] 2008; 25: 63-66
  5. Reisner A, Stiles RG, Tindall SC. Diffuse idiopathic skeletal hyperosteosis causing acute thoracic myelopathy: A case report and discussion. Neurosurgery 1990; 26: 507-511
  6. Wilson FM, Jaspan T. Thoracic spinal cord compression caused by diffuse idiopathic skeletal hyperosteosis (DISH). Clin Radiol 1990; 42: 133-135
  7. Sarı H, Sucuoğlu H, Örnek Nİ, Mısırlıoğlu TÖ, Uludağ M. Diffüz idiopatik iskeletal hiperostozlu (DISH) hastada posterior vertebral osteofit ve ligamentum flavum ossifikasyonuna bağlı üst torakal miyelopati gelişimi. Türk Fiz Tıp Rehab Derg 2012; 58: 342-343
  8. Shapiro S. Cauda equina syndrome secondary to lumbar disc herniation. Neurosurgery 1993; 32: 743747
  9. GardnerA, Gardner E, Morley T. Cauda equina syndrome: a review of the current clinical and medico-legal position. Eur Spine J. 2011 May; 20: 690-697
  10. Kawabori M, Kazutoshi H, Akino M, Yano S, Saito H, Iwasaki Y. Cervical myelopathyby C1 posterior tubercle impingement in a patient with DISH. Spine (PhilaPa 1976) 2009; 34:E709-711
  11. Sreedharan S, Li YH. Diffuse idiopathic skeletal hyperostosis with cervical spinal cord injury -a report of 3 cases and a literatur ereview. Ann Acad Med Singapore 2005; 34: 257-261
  12. Goto S, Tanno T, Moriya H. Cervical myelopathy caused by pseudoarthrosis between the atlas and axis associated with diffuse idiopathic skeletal hyperostosis. Spine (PhilaPa 1976) 1995; 20: 2572- 2575
  13. Oostveen JC, van de Laar MA, Tuynman FH. Anterior atlantoaxial subluxation in a patient with diffuse idiopathic skeletal hyperostosis. J Rheumatol 1996; 23: 1441-1444
  14. Guo Q, Ni B, Yang J, Zhu Z, Yang J. Simultaneous ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum causing upper thoracic myelopathy in DISH: case report and literatur ereview. Eur Spine J 2011; 20(Suppl 2