Non-inflammatory enthesopathies of the spine: a diagnostic approach

Ankylosing vertebral hyperostosis, or hyperostotic disease, is an ossificat ion of the entheses, the regions of insertion of tendons, ligaments or join t capsules into the bone. These ossifications create intervertebral bridges (ossifications of the common anterior, lateral and posterior intervertebra l ligaments as well as of the ligamentum flavum), which are responsible for the potential signs of the disease: back and neck pain and stiffness, spin al cord compression at the cervical level and lumbar canal stenosis at the lumbar level. The bony epiphyses are the sites of bony appositions, or enth esophytes, which may compromise joint mobility and increase the risk of sec ondary osteoarthritis, causing hip and knee disorders in particular. These degenerative joint diseases may eventually necessitate total replacement. I n this case, the risk of re-ossification around the prosthesis must be aver ted by the immediate postoperative prescription of anti-inflammatory medica tion for 1-2 weeks.