윤상인두근 기능부전과 광범위특발골격뼈형성과다증으로 인한 연하곤란 환자의 치료: 증례 보고

Lim Chae Hwan,Lee Hyo Jeong,박윤길 대한연하장애학회 2022 대한연하장애학회지 Vol.12 No.1

Cricopharyngeal dysfunction is a disorder in which excessive tension in the upper esophageal sphincter occurs leads to dysphagia. Diffuse idiopathic skeletal hyperostosis is a disease in which excessive bone formation is widely observed in various parts of the body including the cervical spine. This case report shows a dysphagia patient who had cricopharyngeal dysfunction combined with diffuse idiopathic skeletal hyperostosis. A male patient suffering from dysphagia for 4 months visited the hospital. He was examined by using a videofluoroscopic swallow study, which confirmed simultaneous cricopharyngeal dysfunction and diffuse idiopathic skeletal hyperostosis. Considering the advanced age of the patient, a botulinum toxin injection was first administered to treat his cricopharyngeal dysfunction. The patient showed partial improvement with this treatment. However, dysphagia persisted due to in-complete occlusion of the epiglottis by the anterior osteophyte. The patient was in good general condition; there-fore a partial cervical corpectomy was performed for cervical diffuse idiopathic skeletal hyperostosis. The patient showed complete recovery from dysphagia post-surgery. In conclusion, two separate treatments were individually given; a botulinum toxin injection for cricopharyngeal dysfunction and surgery for diffuse idiopathic skeletal hyper-ostosis, and each treatment was confirmed as effective.

Treatment of Thoracolumbar Spinal Fracture Accompanied by Diffuse Idiopathic Skeletal Hyperostosis Using Transdiscal Screws for Diffuse Idiopathic Skeletal Hyperostosis: Preliminary Results

Mehta Gaurav,Hisanori Ikuma,Shinichiro Takao,Yoichi Inoue,Tomohiko Hirose,Keitaro Matsukawa,Keisuke Kawasaki 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.3

Study Design: This retrospective case series enrolled 13 patients who underwent posterior fixation with both transdiscal screws for diffuse idiopathic skeletal hyperostosis (TSDs) and pedicle screws (PSs) to treat spinal injury accompanied by diffuse idiopathic skeletal hyperostosis (DISH). Purpose: To describe the usefulness, feasibility, and biomechanics of TSD. Overview of Literature: Vertebral bodies accompanied by DISH generally have lower bone mineral density than normal vertebral bodies because of the stress shielding effect. This phenomenon tends to makes screw fixation challenging. To our knowledge, solutions for this issue have not previously been reported. Methods: Patients were assessed using the data on surgical time, estimated intraoperative blood loss, mean number of stabilized intervertebral segments, number of screws used, perioperative complications, union rate, and the three-level EuroQol five-dimensional questionnaire (EQ5D-3L) score at the final follow-up. The Hounsfield unit (HU) values of the screw trajectory area, and the actual intraoperative screw insertion torque of TSDs and PSs were also analyzed and compared. Results: The surgical time and estimated intraoperative blood loss were 165.9±45.5 minutes and 71.0±53.4 mL, respectively. The mean number of stabilized intervertebral segments was 4.6±1.0. The number of screws used was 4.9±1.3 for TSDs and 3.0±1.4 for PSs. One death occurred after surgery. The union rate and EQ5D-3L scores were 100% and 0.608±0.128, respectively. The HU value and actual intraoperative screw insertion torque of TSDs were significantly better than those of PSs (p<0.001, p=0.033). Conclusions: We were able to achieve stable surgical outcomes using the combination of TSDs and PSs. The HU value and actual intraoperative screw insertion torque were significantly higher for TSDs than for PSs. Based on these results, when treating thoracolumbar spinal fractures accompanied by DISH in elderly populations, the TSD could be a stronger anchor than the PS.

추나요법 병행치료를 통한 미만성 특발성 골격 과골증(Diffuse Idiopathic Skeletal Hyperostosis : DISH) 환자 치험 1례

윤덕원(Deok Won Youn),정희경(Hui Gyeong Jeong),권오훈(Oh Hoon Kwon),황동규(Dong Gyu Hwang),김은지(Eun Ji Kim),김정훈(Jeong Hoon Kim),정진수(Jin Soo Jung),김지원(Ji Won Kim) 대한스포츠한의학회 2017 대한스포츠한의학회지 Vol.17 No.1

Objectives The Purpose of this study is to evaluate the clinical effectiveness of cotreatment with Chuna Manual Therapy for Diffuse Idiopathic Skeletal Hyperostosis. Methods The patient treated by Chuna Manual Therapy for 14days. Treatmental effects were measured by using the Verbal Numeric Rating Scale(VNRS), Neck Disability index(NDI) and Cervical spine Range of Motion(C-spine ROM). Results VNRS decreased 8 to 3, NDI also reduced 44 to 20, and Cervical spine Range of Motion was improved Flexion 5°, Extension 5°, Lat.bending 5°/5°, Rotation 10°/10° to Flexion 30°, Extension 30°, Lat.bending 4 0°/40°, Rotation 60°/60° after Chuna Manual Therapy. Conclusions Cotreatment with Chuna Manual Therapy can be effective treatment for a patient with Diffuse Idiopathic Skeletal Hyperostosis. Further clinical studies are needed to verify the findings.

Successful Intubation using Angulated Video Laryngoscopy and a Back-up Head-elevated Position in a Patient with Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

( Eun Hee Chun ),( Mi Hwa Chung ),( Eun Mi Choi ),( Jung Eun Kim ),( In-jung Jun ),( Jong Hee Park ),( Joon-sang Hyeon ),( Joo Hyun Jun ) 경희대학교 경희의료원 2020 慶熙醫學 Vol.35 No.1

Ligamentous ossification of the anterolateral spine is characteristic of diffuse idiopathic skeletal hyperostosis (DISH; i.e., ankylosing hyperostosis or Forestier’s disease). Cervical spine involvement can make airway management difficult during intubation. A patient with a history of impossible intubation resulting from the presence of large anterior cervical osteophytes presented for removal of the osteophytes. Preoperative diagnostic imaging revealed a larynx anteriorly displaced by osteophytes. The osteophytes were on the anterior surfaces of the third to seventh cervical vertebrae. Successful intubation was performed using an angulated curved video laryngoscope and a back-up head-elevated position (BUHE). The angulated curved video laryngoscope and BUHE position provided a good laryngeal view in a patient with DISH who had a larynx with osteophyte-associated anterior displacement. We suggest that these methods are an alternative for anesthesiologists during airway management of patients with difficult intubation.

CT Findings of May–Thurner Syndrome in Diffuse Idiopathic Skeletal Hyperostosis: A Case Report

Jiwook Jeong,Tae Eun Kim 대한영상의학회 2023 대한영상의학회지 Vol.84 No.4

May-Thurner syndrome (MTS) is a rare cause of deep vein thrombosis. Several cases of MTS because of various causes have been reported. However, MTS due to osteophytes in patients with underlying diffuse idiopathic skeletal hyperostosis (DISH) has not been reported in English literature, to the best of our knowledge. Here, we present the CT findings of MTS in patient with DISH.

범발성 특발성 골격과골 증후군에 의한 우측 하지의 점진적인 마비

최한주,오성범,박현수 대한응급의학회 2012 大韓應急醫學會誌 Vol.23 No.1

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a common disorder characterized by ossification and calcification of soft tissues such as the enthuses and joint capsules, particularly affecting the spine. This condition affects approximately 3~30% of men older than 50 years of age. We present the case of a 39-year-old woman diagnosed with DISH combined with extensive ossification of the posterior longitudinal ligament (OPLL)and ossification of ligamentum flavum (OLF). The emergency physician should understand the typical radiologic findings associated with DISH and its clinical presentations in order to diagnose and treat this problem.

Activities of Daily Living after Surgical Treatment for Osteoporotic Vertebral Fracture with or without Diffuse Idiopathic Skeletal Hyperostosis: A Retrospective Single-Institutional Study

Kato Shinichi,Terada Nobuki,Niwa Osamu 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.6

Study Design: This investigation was a retrospective observational study.Purpose: The aim of this study was to evaluate whether having diffuse idiopathic skeletal hyperostosis (DISH) as a comorbidity affects the patient’s ability to perform activities of daily living (ADL) after surgical treatment for osteoporotic vertebral fracture (OVF). Overview of Literature: A few studies have extensively evaluated elderly patients with comorbidities such as DISH and OVFinduced persistent back pain and their ability to perform ADL postoperatively.Methods: In this study, 63 patients (21 men and 42 women) who underwent surgical treatment for OVF were enrolled. Of these patients, 26 had DISH (D+) and 37 did not have DISH (D-). Patient demographic characteristics and surgical, clinical, and radiological findings were compared between those with and without DISH. The change in their ability to perform ADL after surgery was also evaluated.Results: Age, number of comorbidities, and 1-year mortality rate were significantly higher in the D+ group (<i>p</i><0.05). Postoperative Visual Analog Scale (VAS) scores were significantly higher in patients with impaired (n=6, <i>p</i>=0.04) abilities to perform ADL, and improvements in VAS scores were significantly higher in patients with unchanged abilities to perform ADL (n=54, <i>p</i>=0.03) after surgery. The average postoperative VAS scores were 2.2 for the D+ group and 2.3 for the D- group, which were not significantly different.Conclusions: The frequency of OVF with DISH was higher in elderly men with multiple comorbidities and contributed to a higher 1-year mortality rate than those in patients without DISH. However, preoperative and postoperative VAS scores and improvements in VAS scores were similar between those with and without DISH. Postoperative impaired ability to perform ADL was associated with old age, high postoperative VAS scores, and little improvements in VAS scores, which were limitedly influenced by DISH. Surgical treatment of OVF combined with DISH is effective and appropriate for elderly patients.

경추 전부 골극 파열에 의한 인두강 대량출혈 1예

최성원,왕수건,이진춘,이윤세 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.8

Large anterior cervical osteophytes occur in the process of degeneration of the cervical spine or diffuse idiopathic skeletal hyperostosis. Extensive cervical spine osteophytes can produce dysphagia and laryngeal symptoms, including hoarseness, dysphonia, dyspnea and etc. But spontaneous bleeding is rare manifestation. Dysphagia and airway obstruction can be treated by surgical excision of osteophytes if conservative support fails. We present a case of a 76-year-old patient with massive bleeding from posterior hypopharyngeal wall and progressive dysphagia. When angiographic embolization and endoscopic bleeding control failed, the patient died of uncontrolled hemorrhage, and the subsequent disseminated intravascular coagulation and multi-organ failure.

Spine Fractures of Patients with Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis: Fracture Severity and Injury-Related Mortality at a Level I Trauma Center

Chen Stephen Ryan,Munsch Maria Amelia,Chen Joseph,Couch Brandon Keith,Wawrose Richard Alan,Oyekan Anthony Abimbade,Adjei Joshua,Donaldson William F.,Lee Joon Yung,Shaw Jeremy DeWitt 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.3

Study Design: Retrospective review of prospectively collected cohort.Purpose: To identify differences in treatment and mortality of spine fractures in patients with ankylosing conditions of the spine. Overview of Literature: Ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) are the two most common etiologies of ankylosing spinal disorder (ASD). However, studies on the treatment and outcomes of spine fractures in AS and DISH patients remain few.Methods: Patients presenting with a spine fracture were diagnosed with AS or DISH at a single tertiary care center between 2010 and 2019. We excluded those who lacked cross-sectional imaging or fractures occurring at spinal segments affected by ankylosis, as well as polytraumatized patients. Patient demographics, injury mechanism, fracture level, neurologic status, treatment, and 1-year mortality were recorded. Computed tomography imaging was reviewed by two independent readers and graded according to the indicated AO Spine Injury Classification System. Differences in fracture severity, treatment method, and mortality were examined using Student t -tests, chi-square tests, and two-proportion Z-tests with significance set to p <0.05.Results: We identified 167 patients with spine fracture diagnosed with AS or DISH. Patients with AS had more severe fractures and more commonly had surgery than patients with DISH (p <0.001). Despite these differences, 1-year mortality did not significantly differ between AS and DISH patients (p =0.14).Conclusions: Although patients with AS suffered more severe fractures compared to DISH and more frequently underwent surgery for these injuries, outcomes and 1-year mortality did not differ significantly between the two groups. For patients with ASDs and fractures, outcomes appear similar regardless of treatment modality. Consequently, there may be an opportunity for critical reappraisal of operative indications in ASD and a larger role for nonoperative management in these challenging patients.

DISH (Diffuse Idiopathic Skeletal Hyperostosis) 1예 보고 : A Case Report

황성관,안재인,차지환 최신의학사 1988 最新醫學 Vol.31 No.5