弥漫性特发性骨肥厚（DISH）相关的颈椎前缘骨赘继发进行性吞咽困难和发音障碍：一例报告
Progressive dysphagia and dysphonia secondary to DISH-related anterior cervical osteophytes: A case report.
作者信息
Kumar Manoj, Shahi Prem Bahadur, Adsul Nitin, Acharya Shankar, Kalra K L, Chahal R S
机构信息
Department of Ortho-Spine Surgery, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi, Delhi, India.
出版信息
Surg Neurol Int. 2020 Apr 18;11:69. doi: 10.25259/SNI_61_2020. eCollection 2020.
BACKGROUND
Dysphagia due to diffuse idiopathic skeletal hyperostosis (DISH)-related anterior cervical osteophytes is not uncommon. However, this rarely leads to dysphonia and/or dysphagia along with life- threatening airway obstruction requiring emergency tracheotomy.
CASE DESCRIPTION
A 56-year-old male presented with progressive dysphagia and dysphonia secondary to DISH-related anterior osteophytes at the C3-C4 and C4-C5 levels. The barium swallow, X-ray, magnetic resonance imaging, and computed tomography scans confirmed the presence of DISH. Utilizing an anterior cervical approach, a large beak-like osteophyte was successfully removed, while preserving the anterior annulus. After clinic-radiological improvement, the patient was discharged with a soft cervical collar and nonsteroidal anti-inflammatory drug (NSAID).
CONCLUSION
Large anterior osteophytes in Forestier disease/DISH may cause dysphagia and dysphonia. Direct anterior resection of these lesions yields excellent results as long as other etiologies for such symptoms have been ruled out.
背景
弥漫性特发性骨肥厚（DISH）相关的颈椎前缘骨赘导致的吞咽困难并不少见。然而，这很少会导致声音嘶哑和/或吞咽困难，以及危及生命的气道梗阻而需要紧急气管切开术。
病例描述
一名56岁男性因C3 - C4和C4 - C5水平的DISH相关前缘骨赘出现进行性吞咽困难和声音嘶哑。吞钡造影、X线、磁共振成像和计算机断层扫描证实了DISH的存在。采用颈椎前路入路，成功切除了一个大的喙状骨赘，同时保留了前纤维环。经临床影像学改善后，患者佩戴软颈托并服用非甾体抗炎药（NSAID）出院。
结论
Forestier病/DISH中的大型颈椎前缘骨赘可能导致吞咽困难和声音嘶哑。只要排除了这些症状的其他病因，直接前路切除这些病变可取得优异效果。
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