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Vertebral Ligament Amyloid Deposits in Spinal Stenosis

Published online by Cambridge University Press:  18 September 2015

François Gagné*
Affiliation:
Department of Pathology, Laval University, Quebec
*
Service d’anatomopathologie, Hôpital de l’Enfant-Jésus, 1401. 18ième Rue, Québec, PQ. Canada G1J 1Z4
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Abstract

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Objective:

We have searched for amyloid substance in 41 consecutive samples of tissue taken during laminectomies performed to relieve spinal canal stenoses. We also evaluated the relation between the occurrence of deposits and the age of patients.

Methods:

Tissue sections were stained with Congo red; positive areas had to show green dichroism under polarized light.

Results:

Small amyloid deposits were found in fibrous and fibro-elastic (ligamentum flavum) tissues in 14 subjects (34%). After age 60, the frequency was close to 50%. It reached 58% in those aged 70 or over. Our 3 patients aged 80 or more all had deposits. There was also a relation between age and importance of the infiltration. Both sexes appeared evenly involved. Systemic amyloidosis (multiple myeloma) was demonstrated in a single patient. In this case infiltration was slightly more abundant and exceeded ligamentary structures, also involving vascular walls.

Conclusions:

Small amyloid deposits were frequent in our material. Their presence and their abundance were closely related to the age of patients. Rarely, a more important infiltration, exceeding ligamentary structures will perhaps suggest a systemic form of amyloidosis. A few other rare amyloid conditions (amyloidosis associated with prolonged dialysis, amyloid tumour) have been reported to induce spinal canal stenosis. The occurrence of amyloid in vertebral ligaments of non-stenosed elderly persons is not documented; it may represent a new localization of senile amyloidosis.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

References

RÉFÉRENCES

1.Kumar, V., Cotran, RS., Robbins, SL.Basic Pathology, 5 ed. Saunders, 1992, 165170.Google Scholar
2.Kisilevsky, R.Amyloid and amyloidoses: differences, common themes and practical considerations. Modern Pathol 1991; 4: 514518.Google ScholarPubMed
3.Villarejo, F., Perez Diaz, C., Perla, C., Sanz, J., et al. Spinal cord compression by amyloid deposits. Spine 1994; 19: 11781181.CrossRefGoogle ScholarPubMed
4.Vila, N., Hernandez, MV., Alday, M., et al. Compression of the spinal cord by the amyloid tissue in the thoracic vertebral amyloidoma (en espagnol). Neurologia 1994; 9: 162164.Google Scholar
5.Sanchez, R., Praga, M., Rivas Salas, JJ. et al. Compressive myelopathy due to dialysis-associated amyloidosis. Nephron 1993; 65: 463465.CrossRefGoogle ScholarPubMed
6.Allain, TJ., Stevens, PE., Bridges, LR., Phillips, ME.Dialysis myelopathy: Quadriparesis due to extradural amyloid of β2-Microglobulin origin. Br Med J 1991; 296: 752753.CrossRefGoogle Scholar
7.Takeda, T., Sanada, H., Ishii, M., et al. Age-associated amyloid deposition in surgically-removed herniated intervertebral discs. Arthritis and Rheumatism 1984; 27: 10631065.CrossRefGoogle ScholarPubMed
8.Ladefoged, C., Christensen, HE.Congophilic substance with green dichroism in hip joints in autopsy material. Acta Pathol Microbiol Scand, Sect A 1980; 88: 5558.Google ScholarPubMed
9.Goffin, YA., Thoua, Y., Potvliege, PRS.Microdeposition of amyloid in the joints. Ann Rheum Dis 1981; 40: 2733.CrossRefGoogle ScholarPubMed
10.Honig, S., Murali, R.Spinal cord claudication from amyloid deposition. J Rheumatol 1992; 19: 19881990.Google ScholarPubMed
11.D’Agostino, AN., Mason, MS., Quinn, SF.Lumbar spinal stenosis and spondylosis associated with amyloid deposition in the ligamentum flavum. Clin Neuropathol 1992; 11: 147150.Google ScholarPubMed