Dysphagia and dysphonia due to anterior cervical osteophytes: Report of a patient affected by DISH

摘要

Anterior vertebral osteophytes and diffuse idiopathic skeletal hyperostosis (DISH) affecting the cervical spine are rare causes of dysphagia and dysphonia, and tend to affect aged patients. We report the case of a patient affected by DISH complaining of dysphagia and dysphonia due to massive osteophytosis of the anterior cervical spine. Spine X-ray films, direct laryngoscopy and esophagoscopy, cervical Magnetic Resonance Imaging were necessary to achieve a thoughtful characterisation of the osteophytic masses, and allowed the differential diagnosis with all the other causes of dysphagia and dysphonia. In absence of any effective medical therapy, surgery was required to relieve symptoms. Immediate clinical improvement occurred after the surgical resection of the osteophytes via an anterior cervical approach, without instrumented fusion. One and a half years after surgery, both clinical and radiological follow-up were negative for recurrence of the disease. In experienced hands, surgical treatment can beeffective in resolve symptoms; instrumented fusion was not performed because, as found in this patient, disc degeneration in DISH is usually minimal or absent. 2006 Springer-Verlag.