title: Spinal stenosis due to ossified lumbar lesions.
abstract: OBJECTIVE
  Spinal stenosis due to lumbar ossified lesions is a rare pathological entity. The authors retrospectively evaluated the clinical features and surgical results associated with cases involving lumbar ossified lesion-induced stenosis.
  
  
  METHODS
  Data obtained in 20 surgically treated patients with lumbar hyperostotic spinal stenosis were included. To evaluate the background of the disease, body mass index and general complications were assessed. Whole-spine radiological examination was conducted. The presence of ossification of the posterior longitudinal ligament or ossification of the ligamentum flavum was evaluated. Surgical results were classified according to the Japanese Orthopaedic Association (JOA) scale. In the patients in whom neurological deterioration was observed during follow up, the causes of deterioration were reviewed. Seven patients (35%) were obese and six patients (30%) suffered diabetes mellitus. Twelve patients harbored coexisting cervical and/or thoracic ossified lesions. The overall mean JOA score improved from 10.2 to a peak of 22.5; at last follow-up examination the mean JOA score was 20.9. In female and older patients with a long history of preoperative symptoms, a low preoperative JOA score, and other spinal lesions, recovery tended to be poorer. Recovery was poor in one patient, and neurological deterioration due to coexisting ossified spinal lesions occurred in another patient during the follow-up period.
  
  
  CONCLUSIONS
  Because coexisting ossified lesions were frequently seen, whole-spine analysis is recommended. Early diagnosis and appropriate treatment are important to achieve a better surgical outcome.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan. zenji@ms.toyama-mpu.ac.jp
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Oya
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Abe
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kanamori
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Ishihara
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Nogami
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hori
authors.forename: Tomoatsu
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D017846:Longitudinal Ligaments / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D009999:Ossification, Heterotopic / Q000150:complications* / Q000601:surgery; D012189:Retrospective Studies; D012737:Sex Factors; D013130:Spinal Stenosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome