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Clinical Manifestations of Spinal DISH Clinical symptoms in spinal DISH are usually mild and include spinal stiffness and mild intermittent and nonradiating thoracolumbar pain that becomes evident in middle age. Generally, no significant change occurs in normal spinal mechanics, and the clinical findings are usually mild in comparison with the extent of the radiographic abnormalities. With progression of the disease, pain and stiffness may involve the lumbar and cervical segments [2]. Occasionally, patients with DISH may have severe limitation of spinal mobility and associated postural abnormality as is seen with advanced ankylosing spondylitis [7]. Prominent flowing ossifications of DISH in the cervical spine can cause dysphagia [2, 4, 8]. However, many patients with DISH are asymptomatic and their disease is discovered incidentally [4]. The association of ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum with DISH may explain, in part, the occasional presence of neurologic findings in patients with DISH [2, 9]. Sharma et al. [10] showed in retrospective analysis that 15% of patients with DISH presenting to a particular neurosurgical unit had serious neurologic manifestations requiring neurosurgical intervention. |
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qk850218(金币+5, 翻译EPI+1):谢谢 2010-12-06 20:40:23
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脊椎DISH（弥漫性特发性骨质增生症）的临床表现 脊椎DISH的临床症状表现通常比较轻微，表现为脊椎僵硬，间歇性轻微胸腰部疼痛，步入中年后症状变明显。通常情况下，正常的脊柱力学不会发生显著变化，临床表现与x光异常的程度相比也比较轻微。随着疾病的恶化，疼痛和僵硬感会发展到腰椎、颈椎部位；偶尔情况下，DISH患者的脊椎活动严重受限，相关姿势异常，类似于强直性脊柱炎。脊椎段的DISH导致的突出性流动骨化会引起吞咽困难。但许多患有DISH的病人没有症状，病状是附带检查出来的。DISH引起的尾椎后纵韧带骨化合并黄韧带骨化症，或许可以解释DISH病人的神经功能方面症状的偶然存在性。Sharma等在回顾性分析中报道，接受神经外科检查的DISH病人中，有15%的病人患有严重的神经系统病症，需要神经外科的介入。 |
2楼2010-12-06 14:21:01
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