Ankylosis Spondylosis

Diffuse idiopathic skeletal hyperostosis (DISH) is a common disorder of unknown etiology that is characterized by back pain and spinal stiffness. There may be mild pain if ankylosis has occurred. The condition is recognized radiographically by the presence of "flowing" ossification along the anterolateral margins of at least four contiguous vertebrae and the absence of changes of spondyloarthropathy or degenerative spondylosis. Even in patients who present with either lumbar or cervical complaints, radiographic findings are almost universally seen on the right side of the thoracic spine...

Alkaptonuria is a rare genetic disorder caused by deficiency of the enzyme homogentisic acid oxidase, resulting in accumulation of homogentisic acid in various body tissue; it produces a multisystemic disorder with a characteristic bluish-black discolouration of the skin and cartilage, termed ochranosis. Ochranosis primarily involves the large joints of the body including the spine. Spinal involvement produces loss of flexibility and ankylosis of the thoracic and lumbar segments. The clinical presentation with spondylosis and canal stenosis is common after the third and fourth decades, but intervertebral disc prolapse is unusual in ochranosis...

Long-term follow-up radiographs of patients with anterior cervical fusions demonstrated progressive cervical spondylosis and osteophytes at levels above and below the fusion. The findings may represent a response to altered stresses imposed by the surgery.

In two healthy and two diseased whitefish (Coregonus Wartmanni) taken from Lake Constance (FRG), ankylosis of the vertebral column was investigated both roentgenologically and histologically. Subsequent to the collapse and necrosis of the "residual" spinal cord within the intervertebral spaces, the outside edges of the vertebral bodies come into direct contact. The compression and tensile forces that occur to an increased extent as a result of the instability, lead not only to a remodelling of the vertebral bodies, but also to the formation of spondylotic osteophytes at the edges of the vertebrae and, as a result of periosteal stimulation, to the development of cellular hyaline cartilage, which fills the intervertebral spaces...

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Spondylosis hyperostotica is described by means of a case report. It may cause dysphagia by massive ventral exostoses of the cervical spine. Therapeutic aspects are discussed.

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