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- Title
Myelopathy associated with instability consequent to resection of ossification of anterior longitudinal ligament in DISH.
- Authors
Park, Man-Kyu; Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung
- Abstract
<bold>Purpose: </bold>The presence of prominent OALL (ossification of anterior longitudinal ligament) in the anterior cervical spine has been implicated as a cause of dysphagia. Surgical resection of the OALL is considered effective for the management of diffuse idiopathic skeletal hyperostosis (DISH)-related dysphagia. Although many reports have been published on DISH-related dysphagia, no cases of postoperative cervical instability have been reported thus far. We present a case in which the patient developed myelopathy associated with instability consequent to resection of OALL in DISH.<bold>Methods: </bold>A 62-year-old man presented with progressive dysphagia that persisted for a year. The patient's symptoms were successfully resolved by resection of OALL. Five years after the surgery, the dysphagia resurfaced and was found to be caused by the regrowth of the OALL. A repeat surgery was performed, and the dysphagia disappeared. Eleven months after the second surgery, he visited the hospital with progressive quadriparesis and pain in the cervical region.<bold>Results: </bold>Nine-month follow-up radiologic study revealed cervical instability at the level of C5-6 resulting in myelopathy. The patient underwent decompressive laminectomy and posterior fusion surgery.<bold>Conclusion: </bold>Surgical resection of DISH-related dysphagia typically yields excellent outcomes, but our experience in this case highlights the possibility of OALL regrowth and subsequent cervical instability after resection of OALL.
- Subjects
SPINAL cord diseases; CERVICAL vertebrae injuries; DEGLUTITION disorders; LAMINECTOMY; SPINAL osteophytosis complications; CERVICAL vertebrae; COMPARATIVE studies; COMPUTED tomography; EXOSTOSIS; JOINT hypermobility; MAGNETIC resonance imaging; RESEARCH methodology; MEDICAL cooperation; METAPLASTIC ossification; NECK pain; REOPERATION; RESEARCH; SPINAL fusion; SPINAL osteophytosis; SURGICAL complications; DISEASE relapse; EVALUATION research; DISEASE complications; LONGITUDINAL ligaments; SURGERY
- Publication
European Spine Journal, 2018, Vol 27, p330
- ISSN
0940-6719
- Publication type
journal article
- DOI
10.1007/s00586-017-5236-y