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Diffuse idiopathic skeletal hyperostosis in the cervical spine
1Department of Orthopaedic Surgery, Northwestern University, Northwestern Memorial Hospital, Chicago, IL 60611, USA.
Clinical Orthopaedics and Related Research
|March 17, 1999
Summary
Elderly patients with diffuse idiopathic skeletal hyperostosis-like conditions and neck pain after minor trauma require careful fracture evaluation. Prompt diagnosis and treatment are crucial, as neurological deficits significantly increase mortality risk.
Area of Science:
- Orthopedics
- Neurosurgery
- Rheumatology
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis, and ossification of the posterior longitudinal ligament share pathological similarities.
- These conditions can predispose individuals to severe cervical spinal fractures from minor trauma.
- Fractures may remain undiagnosed until neurological deficits manifest.
Purpose of the Study:
- To investigate the outcomes of cervical spinal fractures in elderly patients with DISH-like pathologies.
- To identify risk factors associated with mortality in this patient cohort.
Main Methods:
- A retrospective study of 29 elderly patients with cervical spinal fractures and DISH-like pathologies.
- Analysis of treatment approaches (surgical vs. conservative) and neurological status.
- Comparison of survival rates based on neurological function and treatment.
Main Results:
- Twenty patients treated surgically had varying neurological outcomes, with three postoperative deaths.
- Nine patients treated conservatively also showed a range of neurological outcomes.
- All patients with intact neurological function, regardless of treatment, survived.
Conclusions:
- Elderly patients with DISH-like pathology, trivial trauma history, and neck pain warrant thorough fracture examination.
- Decreased neurological function is a significant predictor of increased mortality in these patients.
- Early diagnosis and appropriate management are critical for improving outcomes.