Anterior longitudinal ligament in diffuse idiopathic skeletal hyperostosis

Anterior longitudinal ligament in diffuse idiopathic skeletal hyperostosis: Ossified or displaced?

Kuperus, J.S. (University Medical Center Utrecht)
Smit, E.J.M. (University Medical Center Utrecht)
Pouran, B. (TU Delft Biomaterials & Tissue Biomechanics)
van Hamersvelt, R.W. (University Medical Center Utrecht)
van Stralen, Marijn (Universiteit Utrecht)
Seevinck, P.R. (Universiteit Utrecht)
Buckens, C.F. (University Medical Center Utrecht)
Bleys, Ronald L.A.W. (University Medical Center Utrecht)
Weinans, H.H. (TU Delft Biomaterials & Tissue Biomechanics)
Oner, F. C. (University Medical Center Utrecht)
de Jong, P.A. (University Medical Center Utrecht)
Verlaan, J-J (University Medical Center Utrecht)

2018

Diffuse idiopathic skeletal hyperostosis (DISH) is often theorized to be an ossification of the anterior longitudinal ligament (ALL). Using computed tomography (CT) imaging and cryomacrotome sectioning, we investigated the spatial relationship between the ALL and newly formed bone in DISH to test this hypothesis. In the current study, four human cadaveric spines diagnosed with DISH using CT imaging were frozen and sectioned using a cryomacrotome. Photographs were obtained of the specimen at 125 µm intervals. Manual segmentations of the ALL on cryomacrotome photographs were projected onto the three-dimensional reconstructed CT scans. The presence and location of newly formed bone were assessed in relationship to the location of the ALL. The ALL could be identified and segmented on the photographs at all levels. The ALL was located at the midline at levels where no new bone had formed. At the locations where new bone had abundantly formed, the ALL was displaced towards to the contralateral side and not replaced by bony tissue. The displacement of the—morphologically normal appearing—ALL away from the newly formed bone implies that newly formed bone in DISH may not originate from the ALL.

anterior longitudinal ligament
bone/bone biology
computed tomography
cryomacrotome
diffuse idiopathic skeletal hyperostosis
pathogenesis
spine

http://resolver.tudelft.nl/uuid:37e6dd64-0ac6-409b-8611-46276e001981

https://doi.org/10.1002/jor.24020

0736-0266

Journal of Orthopaedic Research: a journal for musculoskeletal investigation, 36 (9), 2491-2496

Institutional Repository

journal article

© 2018 J.S. Kuperus, E.J.M. Smit, B. Pouran, R.W. van Hamersvelt, Marijn van Stralen, P.R. Seevinck, C.F. Buckens, Ronald L.A.W. Bleys, H.H. Weinans, F. C. Oner, P.A. de Jong, J-J Verlaan