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  4. Thoracic spondylolisthesis and spinal cord compression in diffuse idiopathic skeletal hyperostosis: a case report

Thoracic spondylolisthesis and spinal cord compression in diffuse idiopathic skeletal hyperostosis: a case report

Journal of Medical Case Reports, 2017 · DOI: 10.1186/s13256-017-1252-0 · Published: March 1, 2017

SurgeryOrthopedicsResearch Methodology & Design

Simple Explanation

Diffuse idiopathic skeletal hyperostosis (DISH) is typically considered a harmless condition with few symptoms. However, in rare instances, it can lead to neurological issues that require surgery. These neurological complications arise when the ossification process in DISH affects vertebral ligaments, leading to ossification of the posterior longitudinal ligaments and/or ossification of the ligamentum flavum. This case report presents a unique instance of thoracic spondylolisthesis with spinal cord compression in a patient with DISH, a condition not previously documented in medical literature. The patient experienced significant improvement after neurosurgical intervention.

Study Duration
6 months
Participants
A 78-year-old Japanese man
Evidence Level
Level 4, Case Report

Key Findings

  • 1
    The patient presented with gait disturbance and was found to have anterior spondylolisthesis and severe cord compression at T3 to T4 and T10 to T11.
  • 2
    Computed tomography revealed diffuse idiopathic skeletal hyperostosis at T4 to T10.
  • 3
    Partial laminectomy of T10 and posterior fusion of T9 to T12 resulted in resolution of the spinal cord compression and improvement in T2-weighted image signal intensity.

Research Summary

This case report describes a 78-year-old man with DISH who developed thoracic spondylolisthesis and spinal cord compression, a previously unreported condition. The patient's symptoms included gait disturbance and neurological deficits. Imaging revealed spondylolisthesis and cord compression, with DISH noted in the thoracic spine. Surgical intervention, including laminectomy and posterior fusion, resulted in improved spinal cord compression and neurological function.

Practical Implications

Novelty in DISH Complications

This case highlights a rare and previously unreported complication of DISH, expanding the understanding of its potential neurological consequences.

Surgical Intervention Efficacy

The successful surgical intervention demonstrates a viable treatment option for patients with DISH experiencing spinal cord compression due to spondylolisthesis.

Diagnostic Awareness

Clinicians should consider DISH as a potential underlying factor in patients presenting with spondylolisthesis and spinal cord compression, particularly in the thoracic region.

Study Limitations

  • 1
    Single case report
  • 2
    Limited follow-up period
  • 3
    Generalizability to other populations

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