Korean J Spine.  2008 Sep;5(3):207-210.

Dysphagia Caused by Anterior Cervical Osteophytes: Different Surgical Outcomes in Three Cases

• Park EK
• Kang SH
• Rhim SC
• Roh SW
• Jeon SR

Abstract

Dysphagia is a common symptom in elderly individuals, and anterior cervical osteophytes have been implicated as a rare, but surgically correctible cause of dysphagia. In previous studies, surgical treatment of such cases has been associated with immediate symptomatic relief. The surgical outcome of three cases was reviewed retrospectively. A 74-year-old male with progressive dysphagia and aspiration pneumonia attributed to diffuse ossification of anterior longitudinal ligaments (OALL) from C3 to T1 was treated by standard anterior approach and subtotal resection was done. The second case was a 64-year-old male with dysphagia due to diffuse idiopathic skeletal hyperostosis (DISH) underwent anterior DISH resection. The last was a 79-year-old male with progressive dysphagia and aspiration pneumonia due to OALL treated with osteophyte resection. Symptomatic relief was achieved immediately in the first two cases, however, recurrence occurred after seven years in the first case and osteophyte regrowth without symptom in the second case after 33 months follow up. The last case did not have any symptomatic improvement and mechanical obstruction was noted intraoperatively within esophagus. Surgical complication resulting emergency hematoma evacuation and tracheostomy occurred in the second case with complete recovery. Surgical complications, reossification with symptomatic recurrence, and possible plural or mixed causes of dysphagia are all reasons for caution prior to the decision to intervene surgically in such cases.

Keyword

Cervical vertebrae; Diffuse idiopathic skeletal hyperostosis; Dysphagia; Operation; Osteophyte; Outcomes

MeSH Terms

Aged
Cervical Vertebrae
Deglutition Disorders
Emergencies
Esophagus
Female
Follow-Up Studies
Hematoma
Humans
Hyperostosis, Diffuse Idiopathic Skeletal
Longitudinal Ligaments
Male
Middle Aged
Osteophyte
Pneumonia, Aspiration
Recurrence
Retrospective Studies
Tracheostomy