Mineo J F, Person H, Dam Hieu P, Bostan A, Besson G
Service de Neurochirurgie, CHU La Cavale Blanche, 29609 Brest Cedex.
Neurochirurgie. 2001 May;47(2-3 Pt 1):140-2.
A 74-year-old man had acute complete dysphagia due to esophageal compression cause by a degenerative osteophye on C4-C5. Functional improvement was immediate after surgical removal of the osteophyte via an anterior cervical approach. Reports in the literature show that vertebral hypertrophic spurs causing dysphagia result from bony degeneration or idiopathic causes (diffuse idiopathic skeletal hyperosteosis: DISH). Surgery is mandatory if medical care fails and dysphagia is complete. Discetomy-graft is indicated for degenerative lesions and simple removal of the bony spur for ossification of the anterior longitudinal ligament in DISH. In DISH, the cervical disc is not implicated but in degenerative disease it is the most important factor in the development of osteophytes.
一名74岁男性因C4 - C5椎体退变形成的骨赘压迫食管导致急性完全性吞咽困难。经颈前路手术切除骨赘后功能立即改善。文献报道显示，导致吞咽困难的椎体肥大性骨赘由骨质退变或特发性病因（弥漫性特发性骨肥厚：DISH）引起。如果内科治疗无效且吞咽困难为完全性，则必须进行手术。对于退变病变，行椎间盘切除植骨术；对于DISH患者的前纵韧带骨化，单纯切除骨赘即可。在DISH中，颈椎间盘未受累，但在退变疾病中，它是骨赘形成的最重要因素。
