S Sreedharan1, Y H Li. 1. Department of General Surgery, Singapore General Hospital. sreedharan.sechachalm@singhealth.com.sg
Abstract
INTRODUCTION: Diffuse idiopathic skeletal hyperostosis (DISH), though common, is often asymptomatic. However, spinal hyperostosis can predispose the affected to chronic myelopathic symptoms and acute spinal cord injury. CLINICAL PICTURE: We report on 3 patients with DISH, who sustained traumatic cervical cord injuries. Two were tetraplegic at presentation. The radiologic findings of the patients are also discussed. TREATMENT: Both the tetraplegic patients were treated non-surgically in view of high surgical risk. OUTCOME: Both the tetraplegic patients died due to mechanical respiratory failure. CONCLUSIONS: The potential catastrophic neurological sequelae of DISH from relatively minor trauma must be understood. Further studies are needed to aid in evidence-based clinical management of asymptomatic patients with DISH.
INTRODUCTION: Diffuse idiopathic skeletal hyperostosis (DISH), though common, is often asymptomatic. However, spinal hyperostosis can predispose the affected to chronic myelopathic symptoms and acute spinal cord injury. CLINICAL PICTURE: We report on 3 patients with DISH, who sustained traumatic cervical cord injuries. Two were tetraplegic at presentation. The radiologic findings of the patients are also discussed. TREATMENT: Both the tetraplegic patients were treated non-surgically in view of high surgical risk. OUTCOME: Both the tetraplegic patients died due to mechanical respiratory failure. CONCLUSIONS: The potential catastrophic neurological sequelae of DISH from relatively minor trauma must be understood. Further studies are needed to aid in evidence-based clinical management of asymptomatic patients with DISH.
Authors: H C Kranenburg; L A Westerveld; J J Verlaan; F C Oner; W J A Dhert; G Voorhout; H A W Hazewinkel; B P Meij Journal: Eur Spine J Date: 2010-02-02 Impact factor: 3.134