Jiaqi Zhang, Lichen Xu, Dongxue Xia, Wei Tang, Wei Wang
Dalian University, China.
Xinhua Hospital Affiliated with Dalian University, China.
J Int Med Res. 2025 May;53(5):3000605251342673. doi: 10.1177/03000605251342673. Epub 2025 Jun 1.
This report highlights an unusual case of a woman in her 70s who presented with diffuse idiopathic skeletal hyperostosis and an initial symptom of spinal cord compression and associated spinal degeneration. She presented with progressive thoracolumbar pain, bilateral lower limb weakness, and sensory deficits. Imaging showed continuous osteophytes in the anterior and lateral spine, multiple levels of intervertebral space narrowing, marked ligament ossification at T10/11, and severe spinal stenosis. Diffuse idiopathic skeletal hyperostosis was diagnosed and spinal cord compression was significantly reduced after laminectomy. Although diffuse idiopathic skeletal hyperostosis is relatively common in elderly patients, cases of spinal cord compression are still rare, and the combination of intervertebral space stenosis, and ossification of the ligamentum flavum may be misdiagnosed as degenerative spondylopathy. This case suggests the possibility of intervertebral stenosis and ossification of the thoracic ligamentum flavum coexisting with diffuse idiopathic skeletal hyperostosis, highlighting the importance of diagnostic imaging in the early stage of patient management.
本报告重点介绍了一名70多岁女性的罕见病例,该患者患有弥漫性特发性骨肥厚症,最初症状为脊髓受压及相关脊柱退变。她表现为进行性胸腰段疼痛、双侧下肢无力和感觉障碍。影像学检查显示脊柱前侧和外侧有连续的骨赘、多个节段的椎间隙狭窄、T10/11处明显的韧带骨化以及严重的椎管狭窄。诊断为弥漫性特发性骨肥厚症,椎板切除术后脊髓受压明显减轻。虽然弥漫性特发性骨肥厚症在老年患者中相对常见,但脊髓受压病例仍然罕见,椎间隙狭窄和黄韧带骨化的组合可能被误诊为退行性脊椎病。该病例提示了椎间隙狭窄和胸段黄韧带骨化与弥漫性特发性骨肥厚症共存的可能性,凸显了诊断性影像学在患者早期管理中的重要性。