STUDY DESIGN: The authors report a case of a patient with diffuse idiopathic skeletal hyperostosis (DISH) associated with basilar impression resulting in tetraparesis. OBJECTIVE: To describe neurologic compromise associated with DISH. SUMMARY OF BACKGROUND DATA: Neurologic deficits due to DISH are very rare, and only 1 case of basilar impression associated with DISH has previously been reported in the literature. METHODS: Diagnosis was confirmed by radiograph and MRI, which demonstrated basilar impression associated with a hyperintense signal in the spinal cord on T2-weighted sequences. Transoral resection of the dens associated with posterior occipitocervical fixation was performed during the same anesthesia. RESULTS: Postoperative outcome demonstrated regression of the pyramidal signs without recovery of unassisted walking. CONCLUSION: Early MRI should be performed in the evidence of spinal cord suffering in patients with DISH. Transoral approach allowed a good decompression of the spinal cord.
STUDY DESIGN: The authors report a case of a patient with diffuse idiopathic skeletal hyperostosis (DISH) associated with basilar impression resulting in tetraparesis. OBJECTIVE: To describe neurologic compromise associated with DISH. SUMMARY OF BACKGROUND DATA: Neurologic deficits due to DISH are very rare, and only 1 case of basilar impression associated with DISH has previously been reported in the literature. METHODS: Diagnosis was confirmed by radiograph and MRI, which demonstrated basilar impression associated with a hyperintense signal in the spinal cord on T2-weighted sequences. Transoral resection of the dens associated with posterior occipitocervical fixation was performed during the same anesthesia. RESULTS: Postoperative outcome demonstrated regression of the pyramidal signs without recovery of unassisted walking. CONCLUSION: Early MRI should be performed in the evidence of spinal cord suffering in patients with DISH. Transoral approach allowed a good decompression of the spinal cord.