Chia Hua Lim, Mokhtar Sabarul A
Department of Orthopedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, MYS.
Cureus. 2021 May 25;13(5):e15222. doi: 10.7759/cureus.15222.
Disseminated idiopathic skeletal hyperostosis (DISH) is a form of ankylosing spinal disorders, which is at high risk of fracture because of the rigidity of the spinal column and reduced bone quality. The patients with DISH are at higher risk of fall because of the poor muscle tone, rigid spine column, and positive sagittal balance. The management of spinal fractures in these patients proves to be challenging because of the altered biomechanics and alignment of the spine. Furthermore, most patients have multiple comorbidities with high intraoperative burden, and osteoporosis itself will impair any implant purchase of the bone. Here, we report a case of thoracolumbar fracture in DISH where both conservative and surgical approaches were utilized, with unfortunate results in both, and a brief review of the literature on its management.
弥漫性特发性骨肥厚（DISH）是一种强直性脊柱疾病，由于脊柱僵硬和骨质下降，其骨折风险很高。由于肌张力差、脊柱僵硬和矢状面平衡阳性，DISH患者跌倒风险更高。由于脊柱生物力学和对线改变，这些患者脊柱骨折的治疗具有挑战性。此外，大多数患者有多种合并症，术中负担重，骨质疏松本身会影响植入物与骨的结合。在此，我们报告一例DISH患者胸腰椎骨折病例，该病例采用了保守和手术治疗方法，但均效果不佳，并对其治疗的相关文献进行简要综述。
