Laus M, Malaguti M C, Alfonso C, Ferrari D, Zappoli F A, Giunti A
Divisione di Ortopedia e Traumatologia Polichlinico S. Orsola-Malpighi, Bologna.
Chir Organi Mov. 1995 Jul-Aug;80(3):263-71.
Cervical lesions caused by diffused idiopathic skeletal hyperostosis may cause compression of the upper respiratory and digestive paths. Horizontal anterior osteophytes that are not fused can cause dysphagia and dysphonia, large prevertebral ossifications extended or segmental may cause difficulty in breathing. A series of 6 cases with dysphagia, dysphonia, dyspnea due to duffused idiopathic skeletal hyperostosis, with cervical lesions is reported. In 3 cases, affected with moderate dysphagia, conservative treatment with anti-inflammatory drugs and a proper diet allowed for the symptoms to be controlled, and for spontaneous evolution of the lesions to occur, with fusion and remodeling of the compressive osteophytes. These patients continue to be asymptomatic 2-7 years after the first observation. In 3 cases affected with severe respiratory and/or nutrition deficit, the osteophytes and ossifications were surgically removed by prevascular extrapharyngeal approach, and rapid resolution of symptoms ensued. The follow-up 1-2 years after treatment showed that patients were asymptomatic and that radiographically there was no recurrence of lesions.
弥漫性特发性骨肥厚引起的颈椎病变可导致上呼吸道和消化道受压。未融合的水平前骨赘可导致吞咽困难和声音嘶哑，广泛或节段性的椎体前方大骨化可导致呼吸困难。本文报告了6例因弥漫性特发性骨肥厚伴颈椎病变导致吞咽困难、声音嘶哑和呼吸困难的病例。3例患者有中度吞咽困难，采用抗炎药物及适当饮食的保守治疗可控制症状，病变自然进展，压迫性骨赘融合并重塑。首次观察后2至7年，这些患者仍无症状。3例有严重呼吸和/或营养障碍的患者，通过血管前咽外入路手术切除骨赘和骨化，症状迅速缓解。治疗后1至2年的随访显示患者无症状，影像学检查未发现病变复发。
