Abstract
Skeletal fluorosis was reported as a disease endemic to an area in the Madras Presidency of Indian in 1937 and prior to this, it was known as an occasional disease. There are two endemic areas in India, one in Punjab and the other in Andhra Pradesh State. This disease is also endemic in some parts of China and Africa. The manual labourers are more frequently affected as they consume huge quantities of water with high fluoride levels. The cervical spine is often affected, manifesting as cord compression. Forty cases of fluorotic cervical cord compression, who underwent surgery are studied regarding their clinical features, radiological aspects and outcome following surgery. In selected cases of cervical fluorotic myelopathy, surgical decompression appears to be necessary and also rewarding.
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Fluorotic cervical compressive myelopathy, 20 years after laminectomy: A rare event
BACKGROUND: Spinal cord compression in flourosis is a common complication. These complications are mainly due to compression of the spinal cord by thickening and ossification of posterior longitudinal ligament and ligamentum flavum. Surgical decompression is the treatment of choice for fluorotic spinal cord compression. The recurrence of spinal cord compression
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Neurological complications of endemic skeletal fluorosis, with special emphasis on radiculo-myelopathy
The results of surveys carried out between 1976 and 1985 in the fluorosis-endemic area of the Ethiopian Rift Valley is summarised, with emphasis on the neurological complications resulting from the crippling osteofluorosis. The neurological manifestations in the forms of myelopathy with and without radiculopathy (respectively 72% and 28%) occurred after exposure
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Ossification of the transverse atlantal ligament associated with fluorosis: a report of two cases and review of the literature
STUDY DESIGN: Two cases of ossification of the transverse atlantal ligament (OTAL) are reported, and the literature is reviewed. OBJECTIVE: To report two cases of OTAL, which share fluorosis as a possible etiologic link. SUMMARY OF BACKGROUND DATA: OTAL, a rare phenomenon, may cause upper cervical canal stenosis and spastic quadriparesis. However,
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Thoracic myelopathy from coincident fluorosis and epidural lipomatosis
Skeletal fluorosis is rare in North America. It can present with back pain and extremity weakness. Immobilization of the spine and the extremity joints can occur. It is usually caused by abnormally increased oral fluoride intake over many years. Epidural lipomatosis is usually caused by idiopathic obesity or corticosteroid use.
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Chronic fluoride intoxication with fluorotic radiculomyelopathy.
This case of a patient with chronic fluoride intoxication, extensive osteosclerosis, and fluorotic radiculomyelopathy is believed to be the first reported froni the United States. The development of advanced fluorosis in this patient exposed to drinking vater with less than 4 ppm of fluoride was unusual and with probably a
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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.
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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.
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"Pre-Skeletal" Fluorosis
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.
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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.
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Fluoride & Osteomalacia
One of fluoride's most well-defined effects on bone tissue is it's ability to increase the osteoid content of bone. Osteoid is unmineralized bone tissue. When bones have too much of it, they become soft and prone to fracture -- a condition known as osteomalacia. As shown below, fluoride has repeatedly been
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