Abstract
Neurological involvement in fluorosis occurs in the advanced stage of the disease and is due to compression of the spinal cord and/or nerve roots. There are only a few reports on the role of surgical management of these cases in the medical literature. Five cases of fluorosis from the endemic areas of Uttar Pradesh, India, had associated cervical cord compression. Their mean age was 43 yr (range 35-50), and all cases were manual laborers. Three patients with blocked cervical subarachnoid space on myelography underwent laminectomy using local anesthesia. All three cases improved significantly after surgery. The usefulness of laminectomy in selected cases of cervical cord compression due to fluorosis is suggested.
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Skeletal fluorosis with neurological complications
A case of skeletal fluorosis with spinal cord compression from Kekirawa following consumption of water with high fluoride content for about 20 years is described. The observations of other workers and the present case report show that more extensive field studies among vulnerable populations is indicated in this region. The need to
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Fluorosis in Nalgonda District, Hyderabad-Deccan
Details of inviestigations of 32 cases of skeletal fluorosis with neurological manifestations are described. The results of the eighth-nerve functions are reported. The probable factors responsible for early skeletal changes in patients from Kamaguda are discussed. A case is described in which excretion of previously stored fluoride continued in the
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[Diagnosis and treatment of hematoma-induced spinal cord injury after operation for fluorosis cervical canal stenosis].
Objective: To study the causes of hematoma-induced spinal cord injury after surgical treatment of fluorosis cervical canal stenosis (FCCS) so as to conclude the methods for early diagnosis and treatment. Methods: A retrospective review was conducted on 329 cases of FCCS undergone expansive laminoplasty (ELOP) between 2006 and 2009.Eighteen out of
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Changes in basic metabolic elements associated with the degeneration and ossification of ligamenta flava
OBJECTIVE: To determine the association between levels of basic metabolic elements and degeneration and ossification of the ligamentum flavum (LF). SUBJECTS: Fourteen consecutive patients with degenerative lumbar stenosis, 11 with ossification of the thoracic ligamenta flava, and 11 control subjects. METHODS: The basic elements of calcium (Ca), phosphorus (P), magnesium (Mg), zinc
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Intraosseous schwannoma of the cervical spine associated with skeletal fluorosis
Intraosseous Schwannoma of the cervical spine is very rare. Its association with skeletal fluorosis is also extremely rare. A case of successfully treated intraosseous neurofibroma of the cervical spine associated with skeletal fluorosis causing tetraparesis is reported. The clinical features, diagnostic aspects and the management is described and the literature
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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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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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"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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X-Ray Diagnosis of Skeletal Fluorosis
In 1937, Kaj Roholm published his seminal study Fluorine Intoxication in which he described three phases of bone changes that occur in skeletal fluorosis. (See below). These three phases, which are detectable by x-ray, have been widely used as a diagnostic guide for detecting the disease. They describe an osteosclerotic bone disease that develops first in the axial skeleton (the spine, pelvis, and ribs), and ultimately results in extensive calcification of ligaments and cartilage, as well as bony outgrowths such as osteophytes and exostoses. Subsequent research has found, however, that x-rays provide a very crude measure for diagnosing fluorosis since the disease can cause symptoms and effects (e.g., osteoarthritis) before, and in the absence of, radiologicaly detectable osteosclerosis in the spine.
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