title: Spontaneous symptomatic pseudoarthrosis at the l2-l3 intervertebral space with diffuse idiopathic skeletal hyperostosis: a case report.
abstract: Pseudoarthrosis at the intervertebral space in patients with ankylosing spondylitis has occasionally been reported, but symptomatic pseudoarthrosis at the intervertebral disc level is rare in patients with diffuse idiopathic skeletal hyperostosis (DISH). Here, we report a case of symptomatic pseudoarthrosis at the L2-L3 intervertebral space that was diagnosed based on clinical history. We first performed L1-L5 fixation, but back-out of the pedicle screw occurred in the early postoperative phase and may have been caused by a short fixation range and concomitant Parkinson's disease. However, the prognosis of the case was favorable after a second surgery. This case indicates that a fixation range of at least 3 above and 3 below is necessary for bone fracture of a thoracolumbar vertebra and pseudoarthrosis in patients with DISH.
authors.affiliation: Department of Orthopaedic Surgery, Toho University School of Medicine, 6-11-1 Omori-Nishi Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Iida
authors.forename: Yuichirou
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Katsunori
authors.initials: K
authors.lastname: Fukutake
authors.forename: Ryo
authors.initials: R
authors.lastname: Takamatsu
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Suzuki
authors.forename: Wataru
authors.initials: W
authors.lastname: Shishikura
authors.forename: Shintaro
authors.initials: S
authors.lastname: Tsuge
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sekiguchi
authors.forename: Akihito
authors.initials: A
authors.lastname: Wada