Spinal Cord Injury in Diffuse Idiopathic Skeletal Hyperostosis: A case report

Kim, Jeong A; Han, Soo Jeong; Lee, Ju Kang; Lee, Chyung Ki

Abstract

Diffuse idiopathic skeletal hyperostosis(DISH) is a relatively common disorder. It is a noninflammatory disease occuring predominantly in middle aged elderly men characterized by calcification and ossification of the anterolateral aspects of vertebral column. It's clinical manifestations are minor: usually cervical stiffness, trunk stiffness and moderate pain. However some severe neurologic complications can occur due to spinal cord compression. We report a case with DISH who got spinal cord injury after minor trauma. A 65-year-old man admitted to the neurosurgery department with a complaint of weakness in lower extremities and paresthesia in upper extremities which were developed after slip down. He had a 10 year history of slowly progressive neck stiffness and weakness in lower extremities. Plain X-ray does not reveal any evidence of fracture in cervical spine or sacroilitis but showed calcification of the anterior longitudinal ligament. The disc spaces were maintained well. MRI showed ossification of the posterior longitudinal ligament causing severe narrowing of the vertebral canal and compression of the spinal cord. Under the diagnosis of spinal cord injury with DISH, the patient was treated conservatively. Despite these treatment, neurologic impairment aggrevated. Surgical decompression of cervical and thoracolumbar spinal cord was done and the patient improved to the quadcane ambulation level.