Diffuse Idiopathic Skeletal Hyperostosis ResearchDysphagia Due to Diffuse Idiopathic Skeletal Hyperostosis of the Cervical Spine.Primary Author: Ihsan Solaro?luPrimary Author: Ankara Ataturk Research and Education Hospital, Department of Neurosurgery, Ankara, Turkey.Date Published: 2008 12 24Abstract: Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease is a common disorder of unknown etiology that is characterized by ossification of the anterior longitudinal ligament of the spine and various extra-spinal ligaments. We present the case of a 54-year-old woman with progressive dysphagia due to DISH of the cervical spine, which is a relatively rare pathology in neurosurgical practice. The cervical osteophytes extending from C2 to C4 and external compression of the pharyngoesophageal segment by the large osteophytes were demonstrated by X-ray, magnetic resonance imaging, and computed tomography. Surgical removal of the large osteophytes and a shortterm nonsteroidal anti-inflammatory drug regimen led to the resolution of dysphagia. The clinical manifestations, diagnosis, and treatment of this unusual condition are discussed.
Diffuse idiopathic skeletal hyperostosis as a cause of progressive dysphagia: a case report.Primary Author: Constantine ConstantoyannisPrimary Author: Date Published: 2008 12 24Abstract: ABSTRACT: BACKGROUND: Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis (DISH), is an idiopathic rheumatological abnormality in which exuberant ossification occurs along throughout the body, but most notably the anterior longitudinal ligament of the spine. Case Presentation. We report on a patient with progressive difficulty in swallowing and dysphagia, resulting in weight loss over the last two years. Radiological evaluation, (x-rays and Magnetic resonance imaging), confirmed the diagnosis of DISH, and revealed marked compression of the esophagus at the C5-6 level, due to excessive ossification of the anterior longitudinal ligament of the cervical spine. The patient was treated with anterior cervical approach for removal of the hyperostosis without fusion. He had marked improvement in swallowing function and was able to resume a normal diet after one month. CONCLUSION: Diffuse idiopathic skeletal hyperostosis or Forestier's disease is an uncommon etiology of difficulty in swallowing and progressive dysphagia. Surgical excision of the cervical osteophytes typically leads to excellent symptomatic results.
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