Siasios Ioannis, Pollina John, Dimopoulos Vassilios G
Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Neurosurgery, Buffalo General Medical Center/Kaleida Health, 100 High Street, Buffalo, NY 14209, USA.
Case Rep Emerg Med. 2016;2016:7657652. doi: 10.1155/2016/7657652. Epub 2016 Jun 22.
Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory degenerative disease that affects multiple spine levels and, in combination with osteoporosis, makes vertebrae more prone to fractures, especially in elderly people. We describe a rare case of thoracic fracture in an ankylosed spine in which hemoptysis was the only clinical sign. The patient (age in the early 80s) presented with chest pain and a cough associated with hemoptysis. The patient had no complaints of back pain and no neurological symptoms. Computed tomography (CT) angiography of the chest revealed changes consistent with DISH, with fractures at the T8 and T9 vertebra as well as lung hemorrhage or contusion in the right lung base. CT and magnetic resonance imaging of the thoracic spine showed similar findings, with a recent T8-T9 fracture and DISH changes. The patient underwent percutaneous pedicle screw fixation from T7 to T11 and remained neurologically intact with an uneventful postoperative course.
弥漫性特发性骨肥厚（DISH）是一种非炎性退行性疾病，可累及多个脊柱节段，并且与骨质疏松症共同作用，使椎体更易发生骨折，在老年人中尤为如此。我们描述了一例罕见的强直性脊柱炎胸椎骨折病例，咯血是唯一的临床症状。该患者（80岁出头）出现胸痛和伴有咯血的咳嗽。患者无背痛主诉，也无神经症状。胸部计算机断层扫描（CT）血管造影显示与DISH相符的改变，T8和T9椎体骨折以及右肺底部肺出血或挫伤。胸椎的CT和磁共振成像显示类似结果，有近期的T8 - T9骨折和DISH改变。患者接受了从T7至T11的经皮椎弓根螺钉固定术，术后神经功能完好，病程平稳。
