OBJECTIVETo study the pathogenesis and treatment of gluteal heterotopic ossification caused by injection.

METHODSFrom April 2006 to May 2011, 4 old female patients with gluteal heterotopic ossification caused by injection were treated by resection. The average age was 71 years old ranging from 67 to 76. The illness were bilateral,the clinical character was pain and hard nodules in the both hip. The X-ray, CT and pathology matched the diagnosis of heterotopic ossification. Two of them were treated by totally removing the ossified tissues, and loosing the spastic and adhesive soft tissues. The other two were treated with local resection and soft-tissue lysis.

RESULTSThe wound of all patients healed well, and there were no complication. All patients were followed-up from 2 to 64 months(averaged 26 months). There were no lump and pain in the location of surgical resection.

CONCLUSIONGluteal heterotopic ossification caused by injection is the drug reaction produced by injecting benzyl alcohol or other drugs,and happens in adults. The key for the treatment is to remove part or all of the painful lump,and loose the local fascia and other soft tissues of the gluteal muscles.

Aged ; Buttocks ; Female ; Humans ; Injections, Intramuscular ; adverse effects ; Ossification, Heterotopic ; etiology ; surgery

Abdominal Wall ; pathology ; Humans ; Male ; Mesentery ; pathology ; Middle Aged ; Ossification, Heterotopic ; etiology ; Postoperative Complications ; etiology ; Tomography, X-Ray Computed

OBJECTIVETo assess the different causes of thoracic ossification of the ligamentum flavum (TOLF).

METHODSFrom July 1989 to November 2005, 142 cases were diagnosed the TOLF, in which 121 were operated. The lesions were classified into three types on the basis of the clinical result: (1) In such primary group (Group 1, 90 cases), without incorporation disease and Ca, P and AKP was all normal; (2) In systemic ossified TOLF group (Group 2, 30 cases), 6 cases ankylosing spondylitis, 3 cases DISH, 10 cases fluorosis, 11 cases OPLL; (3) In local spine disease group (Group 3, 22 cases), 5 cases fracture in spine, 4 cases spine TB, 13 cases posterior marginal intraosseous cartilaginous node. Such clinical feature was analysed, moreover surveyed the thoracic kyphosis angle, upper thoracic kyphosis angle, lower thoracic kyphosis angle and the vertebra body wedge change. The effect was assessed using Epstein Scale.

RESULTS(1) In Group 1, the mainly type was connected type (67/90, 74%). The ossified ligamentum flavum was mainly located at the lower thoracic and thoracic-lumber levels. The local type was less. In Group 2, the mainly type was connected type (21/30, 70%). The local type was none. The lesions figure was the most. In Group 3, the local type was the most (18/22, 82%). (2) In Group 1, the ossified ligamentum flavum was mainly located at the upper and lower thoracic levels (225/486, 47%). In Group 2, mainly located at the whole thoracic, some include cervix and lumber. In Group 3, mainly location was related with the location of primary disease. (3) In group 1, the curve was normal in 81% (73/90) of cases. In Group 2, the curve was abnormal in 87% (26/30) of cases. In Group 3, the curve was normal in the 82% (18/22) of cases.

CONCLUSIONSThe TOLF relates with systemic ossify disease, the change of load on the spine, aging and so on. It should be classified according to its causes.

Adult ; Aged ; Female ; Humans ; Ligamentum Flavum ; pathology ; Male ; Middle Aged ; Ossification, Heterotopic ; classification ; etiology ; pathology ; Retrospective Studies ; Thoracic Vertebrae

A lipogranuloma is an inflammatory reactive process associated with exogenous or endogenous lipids, and it's occurrence in the breast has rarely been reported. Osseous metaplasia, which is used to describe bone formation in abnormal locations, can develop from several conditions such as trauma or a tumor. However, few studies have reported benign breast lesions that have been seen as osseous metaplasia. We present a case of a benign calcified breast lesion that developed after a traumatic treatment process called "Bu-Hwang", and it was confirmed as a lipogranuloma with osseous metaplasia. To the best of our knowledge, this is the first reported case of a lipogranuloma with osseous metaplasia in the breast.
Aged ; Breast/*pathology ; Female ; Granuloma/*etiology/pathology ; Humans ; Mammography ; Medicine, East Asian Traditional/*adverse effects ; Metaplasia ; Ossification, Heterotopic/*etiology ; Osteocytes/pathology

Adult ; Fractures, Bone ; surgery ; Humans ; Male ; Ossification, Heterotopic ; diagnostic imaging ; etiology ; Postoperative Complications ; diagnostic imaging ; etiology ; Talus ; injuries ; surgery ; Tomography, X-Ray Computed

Heterotopic calcification following head and neck irradiation has rarely been reported. It usually develops as a late complication of radiotherapy in patients with malignancies, including breast cancer, lymphoma, and genitourinary malignancies. The occurrence of heterotopic calcification in the prevertebral space of the cervical spine has not been described as a late complication of irradiation. Here, we report a case of prevertebral heterotopic calcification in a patient with history of chemotherapy and radiotherapy for tonsil cancer 21 years ago.
Aged ; Calcinosis/*etiology/pathology/radiography ; *Cervical Vertebrae/radiography ; Female ; Humans ; Ossification, Heterotopic/*etiology/radiography ; Radiation Injuries/complications ; Tomography, X-Ray Computed ; Tonsillar Neoplasms/*radiotherapy

OBJECTIVETo investigate the surgical treatment of thoracic ossification of the ligamentum flavum (TOLF) and analysis of the therapeutic effects.

METHODSSix patients with thoracic ossification of the ligamentum flavum were retrospectively studied from October 2006 to October 2009. All of the patients in this group were treated by en bloc hemi-articular process laminectomy. There were 4 males and 2 females, ranging in age from 45 to 66 years, averaged 55.2 years. The evaluate factors including the preoperative and postoperative JOA scores,and the function of the urinary bladder were analyzed.

RESULTSAll the 6 patients were followed after operation. The mean followed-up duration was 10.5 months, ranging from 2 to 18 months. According to JOA evaluation criteria, 4 patients got an excellent result, 1 good and 1 bad. The one patient with bad result had spinal cord compressed for too long time, and the T2-weight MRI showed nonreversible degeneration of spinal cord and combined with schizophrenia. The clinical symptoms improved with varying degrees.

CONCLUSIONThe en bloc hemi-articular process laminectomy is an effective method for ossification of the thoracic ligamentum flavum. A thorough decompression and real-time protection of the spinal cord is the key to the success of surgery.

Aged ; Decompression, Surgical ; Female ; Humans ; Ligamentum Flavum ; pathology ; Male ; Middle Aged ; Ossification, Heterotopic ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies ; Spinal Cord Injuries ; etiology ; Thoracic Vertebrae ; pathology

Acute neurologic deterioration is not a rare event in the surgical decompression for thoracic spinal stenosis. We report a case of transient paraparesis after decompressive laminectomy in a 50-yr-old male patient with multi-level thoracic ossification of the ligamentum flavum and cervical ossification of the posterior longitudinal ligament. Decompressive laminectomy from T9 to T11 was performed without gross neurological improvement. Two weeks after the first operation, laminoplasty from C4 to C6 and additional decompressive laminectomies of T3, T4, T6, and T8 were performed. Paraparesis developed 3 hr after the second operation, which recovered spontaneously 5 hr thereafter. CT and MRI were immediately performed, but there were no corresponding lesions. Vascular compromise of the borderlines of the arterial supply by microthrombi might be responsible for the paraparesis.
*Cervical Vertebrae/pathology/surgery ; Decompression, Surgical/adverse effects ; Humans ; Laminectomy/*adverse effects ; *Ligamentum Flavum/pathology/surgery ; *Longitudinal Ligaments/pathology/surgery ; Male ; Middle Aged ; *Ossification, Heterotopic ; Paraparesis/*etiology

Adult ; Bed Rest ; adverse effects ; Coma ; chemically induced ; complications ; Encephalitis ; complications ; Female ; Humans ; Ossification, Heterotopic ; etiology ; Status Epilepticus ; complications ; drug therapy

BACKGROUNDCervical disc replacement (CDR) as a substitute for traditional fusion surgery has been widely used in treating degenerative cervical disc diseases. The objectives of this study were to assess the clinical and radiological findings for patients with heterotopic ossification (HO) following CDR and to detect the risk factors of HO after CDR.

METHODSA total of 125 patients with symptomatic cervical single- or double-level disc diseases, who underwent CDR procedure with Discover prosthesis in Department of Spine Surgery, Changzheng Orthopedics Hospital from March 2009 to March 2011, were enrolled in this retrospective study. Occurrence of HO was defined by the McAfee classification on cervical lateral X-rays in this study. Prosthesis vertebral ratio (PVR) was used to determine the matching degree between the cervical disc prosthesis and cervical vertebra. Logistic regression analyses were performed to determine the risk factors of HO. Variables evaluated for their association with HO occurrence included age, gender, high-intensity signal in spinal cord, preoperative range of motion (ROM), postoperative ROM, operation level number, and PVR.

RESULTSMean follow-up time was (26.4±5.8) months. All the patients had significant symptoms and neurological function improvements during the follow-up period. The ROM of the operated segment from the preoperative period to the last follow-up was relatively well maintained. The rate of HO in this cohort of patients, who underwent Discover disc, was 27.92% per surgical level and 24.8% per patient by the last follow-up. There were 19 patients (19.79%) with HO in the single-level group while 12 patients (41.38%) in the double-level group.

CONCLUSIONSWe identified preoperative high-intensity signal in spinal cord, postoperative ROM of surgical level, number of operation level, and PVR as significant risk factors for postoperative HO occurrence.

Adult ; Cervical Vertebrae ; surgery ; Female ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; epidemiology ; etiology ; Retrospective Studies ; Risk Factors ; Total Disc Replacement ; adverse effects