To elucidate the etiology of postoperative spinal cord injury (PSCI) for patients undergoing laminectomy for fluorosis thoracic canal stenosis (FTCS) and summarize the methods of diagnosis and treatment.
From 2006 to 2009, a total of 192 FTCS cases underwent laminectomy. Among them, 16 cases with gradual postoperative neural deterioration were finally diagnosed as PSCI on MRI.One case of intraoperative spinal cord injury was excluded so that only 15 cases were included.
All cases were treated immediately with incision cite puncture and dehydration.Neural function recovered after secondary operation as JOA score improved from 3.00 ± 1.14 to 7.72 ± 1.41 at 12 months follow-up.Statistical analysis demonstrated a linear correlation between the diagnosis time and the improvement of JOA score.
Hematoma and fluid leakage are the common reasons of PSCI for FTCS patients. Meticulous hemostasis, usage of artificial dura matter and partial negative pressure drainage are valuable preventive measures.
An uncommon presentation of fluorosis
A 70 years old farmer from Yemen was referred as a case of osteoarthritis of both knees for preoperative rehabilitation procedures. Six years before he developed progressive skeletal stiffness. By 70 years he became dependent for ambulation and many other self-care activities. He showed quadriparesis resulting from compression of spinal cord
Diagnosis and treatment of deforming osteoarthrosis in subjects in contact with fluoride compounds
A comparative study is presented of 378 workers with osteoarthrosis deformans (OD) contacting with fluorine compounds and in 106 patients with primary OD. The diagnostic criteria in these two categories of patients coincided. But the pain syndrome in the joints in professional fluorosis (PF) was associated with ossalgias (85%), tenderness
Comparison of rheumatoid (ankylosing) spondylitis and crippling fluorosis
(1) Fluoride concentrations were determined for autopsy samples of rib, sacrum, ilium, vertebra, adhering soft tissue, and rib marrow from a patient suffering from rheumatoid (ankylosing) spondylitis of 10 years’ duration. The fluoride concentrations were not increased above normal levels. In this case, the increased bone density seen in this
Fluorosis... causing paraplegia... mutilating life...
Fluorosis is thought to be rare in Pakistan but endemic in various parts of the world, especially in India and China. In Pakistan only a few cases have been reported from Thar, Sibbi and Manga Mandi, with probability of fluorosis on MRI findings, supported by high drinking waterfluoride content. Neurological
Total knee arthroplasty for the treatment of knee osteoarthritis caused by endemic skeletal fluorosis
BACKGROUND: Knee osteoarthritis caused by endemic skeletal fluorosis is a complex and chronic systemic disease,which can cause the damage of surrounding bone and sclerotin of knee joint. OBJECTIVE: To investigate the effect of total knee arthroplasty (TKA) in the treatment of knee osteoarthritis caused by endemic skeletal fluorosis. METHODS: Nine patients suffered
Related Studies :
As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.
Fluoride & Spinal Stenosis
Spinal stenosis is a narrowing of the spaces in the spine that results in pressure being placed on the spinal cord and/or nerve roots. Although stenosis can develop without symptoms, it may produce numbness, tingling, pain and difficulty in walking, as well as a heavy/tired feeling in the legs. It is estimated that 250,000 to 500,000 Americans currently have symptoms of spinal stenosis. Skeletal fluorosis is one cause of stenosis.
Skeletal Fluorosis: The Misdiagnosis Problem
It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.
Fluoride & Osteoarthritis
While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.
Symposium on the non-skeletal phase of chronic fluorosis: The Joints
Of 300 patients with endemic skeletal fluorosis 187 (110 children and 77 adults) showed evidence of arthritis. The spine, especially its cervical portion, appeared to be mainly involved; elbow, hip and knee joints followed next in order.
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