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颈椎前路椎间盘切除术后,术中牵引可能诱发弥漫性特发性骨肥厚伴急性吞咽困难。

Intraoperative Traction May Induce Acute Onset Dysphagia With Diffuse Idiopathic Skeletal Hyperostosis After Anterior Cervical Discectomy.

作者信息

Sul Jung Hoon, Yang Joochul, Kim Tae Wan

机构信息

Department of Neurosurgery, VHS Medical Center, Seoul, Korea.

出版信息

Korean J Neurotrauma. 2022 Feb 17;18(1):126-131. doi: 10.13004/kjnt.2022.18.e10. eCollection 2022 Apr.

Abstract

Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic bone-forming disease, and its pathogenesis remains unknown. Moreover, the incidence of DISH increases with age. DISH may be an age-related disorder that occurs more frequently in degenerative spines than in healthy spines. Most patients with DISH of the cervical spine are asymptomatic; however, mechanical compression of the esophagus by the cervical spine can induce dysphagia, hoarseness, and dyspnea. In most cases, dysphagia progresses slowly. Most cases of postoperative dysphagia after anterior cervical spine surgery occurred within 1 month, and most patients recovered spontaneously. Severe dysphagia is relatively uncommon. Here, we report a case of acute-onset dysphagia with DISH that occurred immediately after anterior cervical discectomy. We should consider the possibility of dysphagia occurring immediately after anterior cervical discectomy in patients with DISH, even in those without dysphagia before surgery. Furthermore, surgical treatment for severe postoperative dysphagia associated with DISH may be a good option.

摘要

弥漫性特发性骨肥厚(DISH)是一种全身性骨形成疾病,其发病机制尚不清楚。此外,DISH的发病率随年龄增长而增加。DISH可能是一种与年龄相关的疾病,在退变脊柱中比在健康脊柱中更常见。大多数颈椎DISH患者无症状;然而,颈椎对食管的机械性压迫可导致吞咽困难、声音嘶哑和呼吸困难。在大多数情况下,吞咽困难进展缓慢。颈椎前路手术后吞咽困难多数发生在1个月内,大多数患者可自行恢复。严重吞咽困难相对少见。在此,我们报告1例颈椎前路椎间盘切除术后立即发生急性吞咽困难的DISH病例。对于DISH患者,即使术前无吞咽困难,我们也应考虑颈椎前路椎间盘切除术后立即发生吞咽困难的可能性。此外,针对与DISH相关的严重术后吞咽困难的手术治疗可能是一个不错的选择。

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