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Case Reports
. 2015 Oct;5(5):e78-83.
doi: 10.1055/s-0035-1546954. Epub 2015 Feb 26.

Dysphagia Secondary to Anterior Osteophytes of the Cervical Spine

Alexander C Egerter  1 , Eric S Kim  1 , Darrin J Lee  1 , Jonathan J Liu  1 , Gilbert Cadena  1 , Ripul R Panchal  1 , Kee D Kim  1
Affiliations
Case Reports

Dysphagia Secondary to Anterior Osteophytes of the Cervical Spine

Alexander C Egerter et al. Global Spine J. 2015 Oct.

Abstract

Study Design Retrospective case series. Objective Diffuse idiopathic skeletal hyperostosis (DISH) or Forestier disease involves hyperostosis of the spinal column. Hyperostosis involving the anterior margin of the cervical vertebrae can cause dysphonia, dyspnea, and/or dysphagia. However, the natural history pertaining to the risk factors remain unknown. We present the surgical management of two cases of dysphagia secondary to cervical hyperostosis and discuss the etiology and management of DISH based on the literature review. Methods This is a retrospective review of two patients with DISH and anterior cervical osteophytes. We reviewed the preoperative and postoperative images and clinical history. Results Two patients underwent anterior cervical osteophytectomies due to severe dysphagia. At more than a year follow-up, both patients noted improvement in swallowing as well as their associated pain. Conclusion The surgical removal of cervical osteophytes can be highly successful in treating dysphagia if refractory to prolonged conservative therapy.

Keywords: diffuse idiopathic skeletal hyperostosis (DISH); dysphagia; osteophytes; surgical management.

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Conflict of interest statement

Disclosures Alexander C. Egerter, none Eric S. Kim, none Darrin J. Lee, none Jonathan J. Liu, none Gilbert Cadena, none Ripul R. Panchal, none Kee D. Kim, Royalties: Precision Spine, LDR, Globus; Stock/stock options: Molecular Matrix, Inc.

Figures

Fig. 1
Fig. 1
Case one. Sagittal (A) and three-dimensional sagittal reconstruction (B) computed tomography of the cervical spine obtained at the initial visit in a patient presenting with severe dysphagia with axial image at C4–C5 indicating severe hyperostosis (C).
Fig. 2
Fig. 2
Case one. Lateral radiograph (A) obtained at the initial visit in a patient with severe hyperostosis. (B) Immediate postoperative sagittal computed tomography and (C) lateral radiograph. (D) Three-year postoperative lateral radiograph shows no significant regrowth of osteophytes.
Fig. 3
Fig. 3
Case two. Lateral radiograph (A) and midsagittal computed tomography (CT; B) obtained at the initial visit in a patient with severe osteophyte formation extending from C4 to C7, most significant at C4 as illustrated on axial CT image (C).
Fig. 4
Fig. 4
Case two. Lateral radiographs obtained immediately postoperative (A) with anterior C3–C4, C5–C6, and C6–C7 diskectomy and posterior decompressive laminectomy, C3 to T3 instrumented arthrodesis at 1-year follow-up visit (B) without regrowth of osteophytes.
See this image and copyright information in PMC

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