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Pagetic vertebral ankylosis and diffuse idiopathic skeletal hyperostosis
C Marcelli1, A J Yates, M C Barjon
1Division of Rheumatology, Lapeyronie Hospital, Montpellier, France.
Spine
|February 15, 1995
Summary
Pagetic vertebral ankylosis (PVA) is rare in Paget's disease of the spine, but its association with diffuse idiopathic skeletal hyperostosis (DISH) suggests a potential mechanism for disease spread.
Area of Science:
- Orthopedics
- Rheumatology
- Radiology
Background:
- Paget's disease of the spine can lead to acquired vertebral ankylosis (PVA), a rare complication.
- The formation mechanisms of PVA are not well understood.
- Previous studies suggest a potential link between PVA and diffuse idiopathic skeletal hyperostosis (DISH).
Purpose of the Study:
- To determine the prevalence and anatomical distribution of PVA in patients with Paget's disease of the spine.
- To investigate the mechanisms of PVA formation.
- To assess the relationship between PVA and DISH.
Main Methods:
- Retrospective radiologic analysis of spinal radiographs from 245 patients with Paget's disease.
- Assessment for signs of Pagetic vertebral lesions and spinal lesions of DISH.
Main Results:
- PVA was identified in 4.4% of patients (11 out of 245).
- PVA occurred more frequently in men and was predominantly located in the thoracic spine.
- Eighty percent of patients with PVA also showed signs of DISH, with DISH lesions often adjacent to PVA.
Conclusions:
- The low incidence of PVA suggests intervertebral disc invasion is an uncommon route of Paget's disease progression.
- The association with DISH indicates that bridging osteophytes may be a significant mechanism for intervertebral spread of Paget's disease.
- PVA, while rare, may offer insights into the pathogenesis and spread of spinal Paget's disease, particularly in conjunction with DISH.