![]() ![]() An X-ray revealed intervertebral disc space narrowing and anterior spondylolisthesis at T3/4 and T10/11 (Fig. Cervical and thoracic spine MRI revealed anterior spondylolisthesis and severe cord compression at T3 to T4 and T10 to T11, and high signal intensity on a T2-weighted image at T10/11 (Fig. A neurological examination of muscle weakness of his iliopsoas and quadriceps femoris suggested possible spinal cord compression. Magnetic resonance imaging (MRI) of his lumbar spine revealed lumbar spinal stenosis (LSS). Neurosurgical intervention relieved the patient’s neurological symptoms significantly.Ī 78-year-old Japanese man presented with a 6-month history of gait disturbance. ![]() We report the first case of thoracic spondylolisthesis and spinal cord compression in DISH. ![]() However, thoracic spondylolisthesis and spinal cord compression in DISH has not previously been reported in the literature. Of these, OPLL was responsible in nine cases and OLF in two. found that 11 patients had presented with progressive spinal cord compression or cauda equina syndrome. A retrospective analysis of 74 cases of DISH conducted by Sharma et al. Neurological complications occur in DISH when the pathological process of ossification extends to other vertebral ligaments, causing ossification of the posterior longitudinal ligaments (OPLL) and/or ossification of the ligamentum flavum (OLF). DISH rarely causes neurological complications, as evidenced by isolated case reports on the subject however, if neurological complications do occur, they are often severe enough to warrant major neurosurgical intervention. Neurosurgical intervention resulted in a significant improvement of our patient’s neurological symptoms.ĭiffuse idiopathic skeletal hyperostosis (DISH) has long been regarded as a benign asymptomatic clinical entity with an innocuous clinical course. We report the first case of thoracic spondylolisthesis and spinal cord compression in diffuse idiopathic skeletal hyperostosis. The postoperative magnetic resonance imaging revealed resolution of the spinal cord compression and an improvement in the high signal intensity on the T2-weighted image. He underwent partial laminectomy of T10 and posterior fusion of T9 to T12. Computed tomography revealed diffuse idiopathic skeletal hyperostosis at T4 to T10. A magnetic resonance imaging scan of his cervical and thoracic spine revealed anterior spondylolisthesis and severe cord compression at T3 to T4 and T10 to T11, as well as high signal intensity in a T2-weighted image at T10/11. Case presentationĪ 78-year-old Japanese man presented with a 6-month history of gait disturbance. Thoracic spondylolisthesis with spinal cord compression in diffuse idiopathic skeletal hyperostosis has not previously been reported in the literature. Neurological complications occur when the pathological process of ossification in diffuse idiopathic skeletal hyperostosis extends to other vertebral ligaments, causing ossification of the posterior longitudinal ligaments and/or ossification of the ligamentum flavum. However, if they do occur, the consequences are often significant enough to warrant major neurosurgical intervention. Neurological complications are rare in diffuse idiopathic skeletal hyperostosis. Breaks might require surgery to repair.Diffuse idiopathic skeletal hyperostosis has long been regarded as a benign asymptomatic clinical entity with an innocuous clinical course. DISH can increase your risk of breaking bones in your spine, especially if you have moderate to severe disease. Rarely, this can become serious and might require surgery to remove the bone spurs. The pressure from bone spurs can also cause a hoarse voice or sleep apnea, a sleep disorder in which you stop breathing repeatedly during sleep. ![]() Bone spurs in the neck can put pressure on your esophagus. For instance, DISH in your shoulder can make it difficult to use your arm. Loss of range of motion in the affected joint can make it difficult to use that joint. People with DISH are at risk of certain complications, such as: Long-term use of medications called retinoids, such as isotretinoin (Amnesteem, Claravis, others), which are used to treat skin conditions such as acne, can increase your risk. Other conditions that can raise insulin levels in your body may also increase your risk, including hyperinsulinemia, prediabetes and obesity. People with type 2 diabetes might be more likely to develop DISH than are those who don't have diabetes. DISH is most common in older adults, especially in people older than 50. Doctors have some idea of what can increase your risk of the condition. ![]()
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