PATTERNS OF VERTEBRAL OSSIFICATION AND PELVIC ABNORMALITIES IN PARALYSIS - A STUDY OF 200 PATIENTS

To clarify the characteristics, extent, and frequency of spinal ossifi cation and abnormalities of the sacroiliac joint, symphysis pubis, and hip in paralysis, routine radiographs of the lumbar spine, pelvis, an d abdomen were retrospectively evaluated in 95 quadriplegic, 105 parap legic, and 100 age-matched control patients, with attention to age and race and to spinal level and duration of paralysis. The spinal radiog raphs were evaluated for presence of osteophytes, syndesmophytes, para vertebral ossification, and flowing hyperostosis characteristic of dif fuse idiopathic skeletal hyperostosis (DISH); Che pelvic radiographs w ere used to measure the widths of Che sacroiliac joint, hip, and symph ysis pubis articulations and evaluate for presence of enthesopathy. Bo ne formation around vertebral bodies was often seen in quadriplegic (n = 41 [43%]) and paraplegic (n = 46 [44%]) patients. In quadriplegic p atients, four distinct vertebral ossification patterns were evident: o steophytosis, paraspinal ossification resembling that found in psorias is, syndesmophytosis, and flowing ossification similar to that in DISH . In paraplegic patients, osteophytosis was most frequent. Vertebral o ssification in quadriplegic patients was significantly associated with age (P < .01) and increased in frequency and severity with increasing age.