May 31

Progressive dysphagia and neck pain due to diffuse idiopathic skeletal hyperostosis of the cervical spine: a case report and literature review

http://www.dovepress.com/articles.php?article_id=16283

Progressive dysphagia and neck pain due to diffuse idiopathic skeletal hyperostosis of the cervical spine: a case report and literature review

Case report

Authors: Zhang C, Ruan DK, He Q, Wen TY, Yang PS

Published Date March 2014 Volume 2014:9 Pages 553 – 557

DOI: http://dx.doi.org/10.2147/CIA.S60146

Received: 05 January 2014
Accepted: 29 January 2014
Published: 31 March 2014

Chao Zhang, Dike Ruan, Qing He, Tianyong Wen, Pushan Yang

Department of Orthopedic Surgery, Navy General Hospital, Beijing, People’s Republic of China

Resumen: hiperostosis esquelética idiopática difusa ( DISH) es considerada una artrosis no primario infradiagnosticada y en su mayoría asintomáticos. La etiología de DISH sigue siendo desconocida y los criterios diagnósticos validados están ausentes. Esta condición es aún reconocido radiológicamente solamente. En raras ocasiones , las grandes osteofitos anteriores salientes dan como resultado el choque de esófago y la distorsión que conduce a la disfagia . Se presenta el caso de la disfagia y dolor de cuello progresivo debido a DISH de la columna cervical en un hombre de 70 años de edad , el cual fue extirpado quirúrgicamente con excelentes resultados postoperatorios y una resolución completa de los síntomas. Los estudios de imagen , los hallazgos quirúrgicos y exámenes histopatológicos fueron utilizados para apoyar el diagnóstico . El paciente fue tratado con éxito con la extirpación total de los osteofitos anteriores sin evidencia de recurrencia 12 meses después de la cirugía. En este informe , también discutimos las características clínicas y consideraciones perioperatorias en combinación con una revisión de la literatura . Nuestro paciente ilustra que los médicos deben ser conscientes de esta manifestación clínica poco frecuente como la característica que presenta de DISH en columna cervical. La descompresión quirúrgica a través osteofitectomía es eficaz para los pacientes que fallan al tratamiento conservador.


Palabras clave : hiperostosis esquelética idiopática difusa , columna cervical , disfagia

Abstract: Diffuse idiopathic skeletal hyperostosis (DISH) is considered an underdiagnosed and mostly asymptomatic nonprimary osteoarthritis. The etiology of DISH remains unknown and the validated diagnostic criteria are absent. This condition is still recognized radiologically only. Rarely, large projecting anterior osteophytes result in esophageal impingement and distortion leading to dysphagia. We report the case of progressive dysphagia and neck pain due to DISH of the cervical spine in a 70-year-old man, which was surgically removed with excellent postoperative results and complete resolution of symptoms. Imaging studies, surgical findings, and histopathological examinations were used to support the diagnosis. The patient was successfully treated with total excision of the anterior osteophytes with no evidence of recurrence 12 months after surgery. In this report, we also discuss the clinical features and perioperative considerations in combination with a literature review. Our patient illustrates that clinicians should be aware of this rare clinical manifestation as the presenting feature of DISH in cervical spine. Surgical decompression through osteophytectomy is effective for patients who fail conservative treatment.

Keywords: diffuse idiopathic skeletal hyperostosis, cervical spine, dysphagia


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