Amyloid, Amyloidosis, Primary Amyloidosis of Light Chain Type, Spinal Stenosis, Transthyretin Amyloidosis
Conditions
Keywords
Biopsy, Surgery, Screening
Brief summary
The investigators will prospectively evaluate for the presence of amyloid deposits in ligamentum flavum (yellow ligament) tissue samples obtained from patients undergoing spinal stenosis surgery. Patients who have tissue that stains positive for amyloid will be referred to an amyloidosis specialist.
Detailed description
Similar to carpal tunnel syndrome, spinal stenosis is associated with systemic amyloidosis and presents earlier than cardiac amyloidosis symptoms - 21-45% of ATTR patients and case reports in AL patients. The investigators' recent study found that 10% of older patients undergoing carpal tunnel release surgery were positive for amyloidosis, with 20% of that group presenting with cardiac involvement. 70% of the amyloid-positive group had a history of spinal stenosis and 40% required surgical intervention. Surgical intervention for spinal stenosis could provide an opportunity to screen for amyloidosis through yellow ligament (ligamentum flavum) biopsy. This study will look at the prevalence of amyloidosis in patients undergoing surgical intervention for non-congenital spinal stenosis and spondyloarthropathy. The investigators hypothesize that 10% of such patients will be positive for amyloidosis.
Interventions
PROCEDUREBiopsy
During clinically-scheduled spinal stenosis surgery, ligamentum flavum tissue (which may contain surrounding tissue and subcutaneous fat) that is removed during the procedure will be sent to pathology to be analyzed with amyloid-specific staining.
Sponsors
The Cleveland Clinic
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Inclusion criteria
* Age ≥50 years * Undergoing surgical intervention for non-congenital spinal stenosis and/or spondyloarthropathy * Able to consent
Exclusion criteria
* History of congenital spinal stenosis or congenital spondyloarthropathy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of amyloidosis in older patients undergoing spinal stenosis surgery | Baseline to 30 days | Incidence of amyloid deposits in removed ligamentum flavum tissue of older patients undergoing spinal stenosis surgery |
Countries
United States
Outcome results
None listed