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Cervical myelopathy in diffuse idiopathic skeletal hyperostosis

Case report

Michael T. Stechison and Charles H. Tator

side. Further improvement was documented at 6 months. Discussion A case of progressive cervical myelopathy was presented secondary to a focal fibrous, calcified mass involving the ligamentum flavum in an elderly man with DISH. To our knowledge, no such complication has previously been reported in association with this entity. “Diffuse idiopathic skeletal hyperostosis” is a relatively new term used to describe an old disease known by a variety of synonyms including “Forestier's disease,” “spondylitis ossificans ligamentosa,” and “spondylosis hyperostotica

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Diffuse idiopathic skeletal hyperostosis masquerading as asthma: case report

Karim Mithani, Ying Meng, David Pinilla, Nova Thani, Kayee Tung, Richard Leung, and Howard J. Ginsberg

alternative diagnoses. A detailed history revealed episodes of apnea, dysphagia, and dyspnea worsened on neck flexion. On physical examination, he had diffuse joint tenderness and severely restricted ROM in his cervical spine. CT demonstrated multilevel anterior and posterior bridging osteophytes, and fusion of the uncovertebral joints for at least 4 contiguous vertebrae, consistent with diffuse idiopathic skeletal hyperostosis (DISH) ( Fig. 2 ). The most salient finding was severe tracheal compression by a C7–T1 osteophyte. Other notable abnormalities on CT scans included

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Diffuse Idiopathic Skeletal Hyperostosis

significant facet joint fractures. A 44-year-old man fell from a tractor and sustained an incomplete spinal cord injury. Plain radiographs demonstrated diffuse idiopathic skeletal hyperostosis of the cervical spine and subluxation at C6–7. A computerized tomography scan revealed comminuted facet joint fractures and bilateral locked facets. The magnetic resonance finding of a traumatic disc ( Fig. 1 ) led to a ventral surgical approach without attempts at closed reduction. The disc was removed and distraction then applied to the Caspar posts in an attempt to achieve

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Spinal fractures in the setting of diffuse idiopathic skeletal hyperostosis conservatively treated via orthosis: illustrative cases

Ayman W. Taher, Paul S. Page, Garret P. Greeneway, Simon Ammanuel, Katherine M. Bunch, Lars Meisner, Amgad Hanna, and Darnell Josiah

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier disease, is a type of noninflammatory arthritis principally characterized by excessive calcification of soft tissue in the spine resulting in gradual ossification of the anterior longitudinal ligaments and entheses. 1–3 Hyperostosis of the spine was initially described by Forestier and Rotes-Querol in 1950, the disease was then further characterized and defined as DISH by Resnick et al. 1 , 2 Diagnostic criteria for DISH includes the presence of calcification and ossification in the

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Prognostic factors of balloon kyphoplasty for osteoporotic vertebral fractures with diffuse idiopathic skeletal hyperostosis

Yuji Tsuchikawa, Naosuke Kamei, Kiyotaka Yamada, Toshio Nakamae, Nobuo Adachi, and Yoshinori Fujimoto

T he incidence of osteoporotic vertebral fractures (OVFs) in the elderly is increasing as society ages, impairing the daily activities of the elderly and increasing the economic burden on society. 1 – 3 Conservative treatment of ordinary OVFs was reported to result in good outcomes; 4 however, fractures in the fused part of ankylosing spines with diffuse idiopathic skeletal hyperostosis (DISH) tend to create three columns, which usually have poor clinical outcomes and are indications for surgery. 5 Additionally, conservative treatment of vertebral

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Management of spine fractures in ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis: a challenge

Maximilian Schwendner, Martin Seule, Bernhard Meyer, and Sandro M. Krieg

A nkylosing spinal disorders (ASDs) such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) are complex diseases, especially when it comes to surgical treatment in cases of trauma. AS is a seronegative systemic chronic rheumatic disease. It mainly manifests in the axial skeleton, especially the spine. It is characterized by disruption of bone architecture combined with osteoplastic changes. This results in osteoporosis of the spine with a further increased risk of fractures. 1 As the disease progresses, complete

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Posterior spinal fixation using penetrating endplate screws in patients with diffuse idiopathic skeletal hyperostosis–related thoracolumbar fractures

Takahisa Hishiya, Tetsuhiro Ishikawa, and Mitsutoshi Ota

interpretation of data: all authors. Drafting the article: all authors. Critically revising the article: Hishiya, Ishikawa. Reviewed submitted version of manuscript: Hishiya. Approved the final version of the manuscript on behalf of all authors: Hishiya. Statistical analysis: Hishiya. Study supervision: Ishikawa. References 1 Forestier J , Rotes-Querol J . Senile ankylosing hyperostosis of the spine . Ann Rheum Dis . 1950 ; 9 ( 4 ): 321 – 330 . 14800245 10.1136/ard.9.4.321 2 Resnick D , Shaul SR , Robins JM . Diffuse idiopathic skeletal

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Large aortic pseudoaneurysm after fusion surgery for hyperextension-type lumbar fracture in diffuse idiopathic skeletal hyperostosis: illustrative case

Hirokazu Shoji, Kimihiko Sawakami, Yuki Tanaka, Seiichi Ishikawa, Hiroyuki Segawa, and Takashi Wakabayashi

Spinal fractures in patients with ankylosing spinal disorders (ASD), such as ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis (DISH), are often mechanically unstable. The fractures are usually of the severe types, such as AO spine injury type B or C, even if the cause of injury is a low-energy trauma, such as a fall. 1 These fractures may cause immediate- or late-onset spinal cord injury and neurological deficits after the trauma. Hence, operative management is usually recommended for all patients, except in rare cases of stable fractures

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Negative impact of short-level posterior lumbar interbody fusion in patients with diffuse idiopathic skeletal hyperostosis extending to the lumbar segment

Hideaki Nakajima, Kazuya Honjoh, Shuji Watanabe, Arisa Kubota, and Akihiko Matsumine

, Watanabe, Kubota. Statistical analysis: Honjoh, Watanabe. Study supervision: Matsumine. References 1 Kagotani R , Yoshida M , Muraki S , Oka H , Hashizume H , Yamada H , Prevalence of diffuse idiopathic skeletal hyperostosis (DISH) of the whole spine and its association with lumbar spondylosis and knee osteoarthritis: the ROAD study . J Bone Miner Metab . 2015 ; 33 ( 2 ): 221 – 229 . 10.1007/s00774-014-0583-9 24623190 2 Resnick D , Niwayama G . Radiographic and pathologic features of spinal involvement in diffuse idiopathic

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Outcomes following conservative treatment of extension fractures in the setting of diffuse idiopathic skeletal hyperostosis: is external orthosis alone a reasonable option?

Paul S. Page, Garret P. Greeneway, Wendell B. Lake, Nathaniel P. Brooks, Darnell T. Josiah, Amgad S. Hanna, and Daniel K. Resnick

, Greeneway, Resnick. Drafting the article: Page. Critically revising the article: Page, Josiah, Hanna. Reviewed submitted version of manuscript: Page, Lake, Brooks, Hanna, Resnick. Approved the final version of the manuscript on behalf of all authors: Page. Statistical analysis: Page. Administrative/technical/material support: Page. Study supervision: Page. References 1 Mader R , Verlaan JJ , Buskila D . Diffuse idiopathic skeletal hyperostosis: clinical features and pathogenic mechanisms . Nat Rev Rheumatol . 2013 ; 9 ( 12 ): 741 – 750 . 24189840 2