Matsumoto Koji, Uei Hiroshi, Tokuhashi Yasuaki
Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan.
J Int Med Res. 2019 Aug;47(8):3955-3962. doi: 10.1177/0300060519861451. Epub 2019 Jul 17.
Diffuse idiopathic spinal hyperostosis (DISH) causes various problems, such as adjacent disc dysfunction, pseudarthrosis, or reossification, when spinal surgery is performed or spinal fracture occurs. The authors herein describe a patient with DISH in whom ossification of the anterior longitudinal ligament progressively advanced from the thoracic to sacral vertebrae during a 14-year period. Surgery was performed three times to treat the characteristic problems associated with DISH: abnormal sagittal alignment of the spine, ossification of the posterior longitudinal ligament, reossification of the laminectomy-treated regions and accompanying spinal canal stenosis, pseudarthrosis after spinal fracture, and delayed palsy. DISH-associated problems after spinal fusion are not rare, but this patient developed a particularly large number of problems often seen in the long term after spinal fusion in patients with DISH. Clinicians must be aware of problems being likely to occur in ossification-discontinuous and fragile regions during the postoperative follow-up.
弥漫性特发性骨肥厚（DISH）在进行脊柱手术或发生脊柱骨折时会引发各种问题，如相邻椎间盘功能障碍、假关节形成或再骨化。本文作者描述了一名患有DISH的患者，其前纵韧带骨化在14年期间从胸椎逐渐发展至骶椎。为治疗与DISH相关的典型问题进行了三次手术：脊柱矢状面排列异常、后纵韧带骨化、椎板切除部位再骨化及伴随的椎管狭窄、脊柱骨折后假关节形成以及迟发性麻痹。脊柱融合术后与DISH相关的问题并不罕见，但该患者出现了大量通常在DISH患者脊柱融合术后长期才会出现的问题。临床医生在术后随访期间必须意识到在骨化不连续和脆弱区域可能会出现的问题。
