BMC Musculoskeletal Disorders, 2024 · DOI: https://doi.org/10.1186/s12891-024-08134-1 · Published: December 2, 2024
Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by the ossification of entheses, which can lead to osteophyte formation. This case report discusses a rare instance where a patient with DISH and ossification of the posterior longitudinal ligament (OPLL) experienced cervical spinal cord injury following osteophyte excision. The patient, a 76-year-old male, presented with dysphagia, respiratory insufficiency, and palpitations. Surgical excision of osteophytes was performed to address these issues, but the patient subsequently developed tetraplegia attributed to C5/C6 instability. The study highlights the importance of considering decompression and fusion surgery in patients with DISH and OPLL undergoing osteophyte excision to prevent spinal cord injury. It also suggests that patients requiring long-term mechanical ventilation may benefit from total laryngectomy due to the likelihood of impaired swallowing function recovery.
When planning osteophyte excision for patients with DISH and OPLL, surgeons should consider performing decompression and fusion surgery simultaneously to prevent spinal cord injury.
Patients undergoing osteophyte excision, especially those with pre-existing spinal cord compression or requiring long-term mechanical ventilation, need close monitoring for neurological deficits and swallowing function.
For patients with prolonged mechanical ventilation and impaired swallowing function, total laryngectomy might be considered as a surgical option to prevent microaspiration and pneumonia.