Dąbrowski Mikołaj, Sulewski Adam, Kaczmarczyk Jacek, Kubaszewski Łukasz
Department of Spine Orthopedics and Biomechanics, W. Dega University Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 135/147, 61-545, Poznan, Poland.
W. Dega University Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 135/147, 61-545, Poznan, Poland.
Ann Med Surg (Lond). 2020 Jul 14;57:37-40. doi: 10.1016/j.amsu.2020.07.009. eCollection 2020 Sep.
Diffuse idiopathic skeletal hyperostosis of cervical spine can lead to dysphagia.
A 73-year-old male weighing 110 kg and diagnosed with diffuse idiopathic skeletal hyperostosis in cervical spine with dysphagia. Patient manifested local pain of neck, a gradual limitation of spinal mobility. The surgery decision was based on swallowing problems, not pain in the spine. Before surgery radiographs, magnetic resonance images, computed tomography of the cervical spine and gastroscopy were obtained. Osteophytes were removed from the anterior approach with present otolaryngologist by surgery.
In this case used gastroscopy, CT and MRI for diagnostics. During the procedure we had support otolaryngologist. The patient has not been found a stenosis spinal canal and neurological symptoms. We were removed the ostheophytes. Interbody implants have not been applied.
Disc degeneration disease itself can be asymptomatic or not a dominant problem for the DISH patients. Clinical signs may pharyngoesophageal and tracheal compression, causing dysphagia, shortness of breath and stridor. In this case, the cervical spine was stability and not demonstrated a stenosis in the spinal canal. Isolate removing of the osteophytes without implants in DISH of cervical spine can be enough solution.
颈椎弥漫性特发性骨肥厚可导致吞咽困难。
一名73岁男性，体重110公斤，诊断为颈椎弥漫性特发性骨肥厚伴吞咽困难。患者表现为颈部局部疼痛，脊柱活动度逐渐受限。手术决策基于吞咽问题，而非脊柱疼痛。术前获取了颈椎的X线片、磁共振成像、计算机断层扫描以及胃镜检查结果。通过手术从前路切除骨赘，手术过程中有耳鼻喉科医生在场。
该病例中使用了胃镜、CT和MRI进行诊断。手术过程中有耳鼻喉科医生提供支持。未发现患者存在椎管狭窄及神经症状。我们切除了骨赘，未应用椎间植入物。
椎间盘退变疾病本身对于弥漫性特发性骨肥厚患者可能无症状或并非主要问题。临床症状可能包括咽食管和气管受压，导致吞咽困难、呼吸急促和喘鸣。在本病例中，颈椎稳定性良好，未显示椎管狭窄。对于颈椎弥漫性特发性骨肥厚，单纯切除骨赘而不植入植入物可能就足够了。
