Galiano Klaus, Gotwald Thaddaeus, Maier Hans, Schatzer Reinhold, Obwegeser Alois Albert
Department of Neurosurgery, Leopold-Franzens-University Innsbruck, School of Medicine, Innsbruck, Austria.
Wien Klin Wochenschr. 2005 Mar;117(5-6):234-6. doi: 10.1007/s00508-005-0312-4.
Forestier's disease is a systemic rheumatologic abnormality of unknown etiology, characterized by a flowing ossification of the anterior ligament of the spine. In this case study we report on an atypical appearance of Forestier's disease in a 72-year-old woman. This patient had a one-month history of rapidly progressing dysphonia and dyspnea and at the time of admission was unable to eat. She had been operated for gastric and colon carcinoma seventeen months earlier. Total body CT scans showed a flowing ossification of the anterior ligament between levels C2 and C7 and an osteophyte protruding in the ventral direction at level C2. Before the osteophyte's removal, a tumor screening was conducted to exclude the presence of distant metastases or occult malignancy. Resection of the large osteophyte was performed via a typical ventral-cervical approach with horizontal skin incision. Six months after the procedure, the patient experienced distinct improvement of her condition and was able to eat both pulpy and solid foods again. In this case example, a rapidly progressive dysphagia was not caused by secondary malignancy, as initially speculated, but resulted from a ventral-cervical osteophyte, considered a rare cause for acute development of severe dysphagia. Early diagnosis of Forestier's disease in this patient led to immediate surgical intervention, which proved to be adequate treatment and enabled the patient to make a good recovery.
福里斯特尔病是一种病因不明的全身性风湿性异常疾病，其特征为脊柱前纵韧带出现连续性骨化。在本病例研究中，我们报告了一名72岁女性患者所表现出的非典型福里斯特尔病。该患者有1个月快速进展的声音嘶哑和呼吸困难病史，入院时无法进食。她在17个月前接受过胃癌和结肠癌手术。全身CT扫描显示C2至C7椎体水平的前纵韧带连续性骨化，且C2椎体水平有一骨赘向腹侧突出。在切除骨赘之前，进行了肿瘤筛查以排除远处转移或隐匿性恶性肿瘤的存在。通过典型的颈部前路水平皮肤切口对大骨赘进行了切除。术后6个月，患者病情明显改善，再次能够进食糊状和固体食物。在这个病例中，快速进展的吞咽困难并非如最初推测的那样由继发性恶性肿瘤引起，而是由颈部腹侧骨赘导致，这被认为是严重吞咽困难急性发作的罕见原因。该患者福里斯特尔病的早期诊断导致了立即的手术干预，事实证明这是充分的治疗方法，并使患者得以良好康复。
