RESUMEN
STUDY DESIGN: Case report. OBJECTIVES: To report a case of progressive kyphotic deformity after spinal fusion in a patient with diffuse idiopathic skeletal hyperostosis (DISH). SUMMARY OF LITERATURE REVIEW: DISH is characterized by spinal and peripheral enthesopathy, and is a completely different disease from ankylosing spondylitis (AS). Though DISH can be associated with thoracic kyphosis, no reports have described a progressive thoracolumbar kyphotic deformity after spinal fusion surgery in a DISH patient. MATERIALS AND METHODS: A 47-year-old male presented with pain in the thoracolumbar region. After excluding the possibility of AS and confirming the diagnosis of DISH, we performed spinal fusion for the treatment of a T11-T12 flexion-distraction injury. The kyphotic deformity was found to be aggravated after the first operation, and we then performed corrective osteotomy and additional spinal fusion. Results: The kyphotic deformity of the patient was corrected after the second operation. RESULTS: The kyphotic deformity of the patient was corrected after the second operation. CONCLUSIONS: In DISH patients in whom AS must be excluded in the differential diagnosis, a kyphotic deformity can become aggravated despite spinal fusion surgery, so regular and continuous follow-up is required.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Anomalías Congénitas , Diagnóstico , Diagnóstico Diferencial , Estudios de Seguimiento , Hiperostosis Esquelética Difusa Idiopática , Cifosis , Osteotomía , Enfermedades Reumáticas , Fusión Vertebral , Espondilitis AnquilosanteRESUMEN
Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis(DISH), is a rare condition. It frequently occurs in elderly men, and is mostly asymptomatic. Patients with severe involvement of the cervical spine may, however, develop dysphagia, dysphonia, dyspnea, and foreign body sensation. We decribe that one case of Forestier's disease with dysphagia, successfully treated by surgery, and also present a review the literature.
Asunto(s)
Anciano , Humanos , Masculino , Trastornos de Deglución , Disfonía , Disnea , Cuerpos Extraños , Hiperostosis Esquelética Difusa Idiopática , Osteofito , Sensación , Columna VertebralRESUMEN
Diffuse idiopathic skeletal hyperostosis(DISH) is a relatively common disorder. It is a noninflammatory disease occuring predominantly in middle aged elderly men characterized by calcification and ossification of the anterolateral aspects of vertebral column. It's clinical manifestations are minor: usually cervical stiffness, trunk stiffness and moderate pain. However some severe neurologic complications can occur due to spinal cord compression. We report a case with DISH who got spinal cord injury after minor trauma. A 65-year-old man admitted to the neurosurgery department with a complaint of weakness in lower extremities and paresthesia in upper extremities which were developed after slip down. He had a 10 year history of slowly progressive neck stiffness and weakness in lower extremities. Plain X-ray does not reveal any evidence of fracture in cervical spine or sacroilitis but showed calcification of the anterior longitudinal ligament. The disc spaces were maintained well. MRI showed ossification of the posterior longitudinal ligament causing severe narrowing of the vertebral canal and compression of the spinal cord. Under the diagnosis of spinal cord injury with DISH, the patient was treated conservatively. Despite these treatment, neurologic impairment aggrevated. Surgical decompression of cervical and thoracolumbar spinal cord was done and the patient improved to the quadcane ambulation level.