title: Diffuse idiopathic skeletal hyperostosis associated with risk factors for stroke: a case-control study.
abstract: METHODS
  The incidence of risk factors for cerebrovascular diseases was investigated in patients with diffuse idiopathic skeletal hyperostosis (DISH) and patients with cervical spondylosis.
  
  
  OBJECTIVE
  To investigate the association between DISH and cerebrovascular disease.
  
  
  BACKGROUND
  DISH is a common skeletal disease mainly affecting the anterior and lateral spinal longitudinal ligaments. The principal clinical features are nonradicular pain, stiffness, dysphagia (cervical portion), and associated ossification of the posterior longitudinal ligament.
  
  
  METHODS
  Age- and sex-matched patients were divided into three groups: 45 patients with DISH, 45 patients with cervical spondylosis Grade I and II, and 45 patients with cervical spondylosis Grade III and IV. Anthropometric, laboratory, and magnetic resonance (MR) imaging findings were analyzed.
  
  
  RESULTS
  The values of uric acid (P = 1.60 x 10) and alkaline phosphatase (P = 2.00 x 10) were significantly greater in patients with DISH than in the other groups. Patients with DISH had a significantly higher incidence of ossification of the posterior longitudinal ligament (P = 5.21 x 10). Stiffness was significantly more common in patients with DISH and patients with spondylosis Grade III and IV than in patients with spondylosis Grade I and II (P = 0.000232). The incidence of infarction on MR imaging was significantly higher in patients with DISH than in the other groups (P = 0.0120). The incidence of stenosis or occlusion of a major cerebral artery on MR angiography was significantly higher in patients with DISH than in the other groups (P = 0.00264).
  
  
  CONCLUSIONS
  DISH is associated with increased incidences of risk factors for stroke and cerebrovascular disease.
authors.affiliation: Department of Neurosurgery, Akiyama Neurosurgical Clinic, Nirasaki, Yamanashi, Japan. akinouge@crux.ocn.ne.jp
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Miyazawa
authors.forename: Iwao
authors.initials: I
authors.lastname: Akiyama
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D004057:Hyperostosis, Diffuse Idiopathic Skeletal / Q000150:complications* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D011859:Radiography; D012307:Risk Factors; D013128:Spinal Osteophytosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D020521:Stroke / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*