Fractures of the spine in diffuse idiopathic skeletal hyperostosis.
Fractures of the spine in diffuse idiopathic skeletal hyperostosis.
复制标题
弥漫性特发性骨骼骨质增生引起的脊柱骨折。
DOI：
10.1097/00003086-199106000-00004
复制
发表时间：
1991
影响因子：
4.2
通讯作者：
A. M. Levine
中科院分区：
文献类型：
--
作者：
Dror Paley;Michael L. Schwartz;Perry W. Cooper;William R. Harris;A. M. Levine
弥漫性特发性骨质增生症(DISH)中脊柱骨折的报道很少。在世界文献中仅能找到四个案例。本文报告8例9处骨折的新病例。关键特征是经常延误诊断(8名患者中有3名)，以及即刻和迟发性神经功能缺陷率高(8名患者中有7名)。本组骨折类型有两种。第一种类型发生在脊柱强直节段的中段，累及椎体(五处骨折)。第二种类型发生在融合节段的顶部或底部(四处骨折)。后者为椎间盘破裂或齿状突骨折。这与强直性脊柱炎的脊柱骨折有明显的不同，强直性脊柱炎中的大多数是经椎间盘骨折。这种差异可以基于这两种疾病过程的不同病理基础来解释。对遭受创伤的DISH患者进行仔细评估是至关重要的。这种罕见损伤的治疗应早期稳定脊柱，以避免骨不连、畸形、神经损伤和死亡的并发症。
Fractures of the spine in diffuse idiopathic skeletal hyperostosis (DISH) have rarely been reported. Only four cases could be found in the world literature. Eight new cases with nine fractures are reported in this study. The critical features are the frequent delays in diagnosis (three of eight patients) and the high rate of immediate and delayed neurologic deficit (seven of eight patients). Two fracture patterns occurred in this group. The first type occurred through the midportion of an ankylosed segment of the spine and involved the vertebral body (five fractures). The second type occurred at the top or bottom of a fused segment (four fractures). The latter were disk disruptions or odontoid fractures. This is a marked difference from spinal fractures in ankylosing spondylitis, in which the majority are transdiskal fractures. The difference can be explained on the basis of the different pathology of these two disease processes. Careful evaluation of patients with DISH who sustain trauma is critical. Treatment of this rare injury should be early stabilization of the spine to avoid complications of nonunion, deformity, neurologic injury, and death.