Cervical myelopathy in diffuse idiopathic skeletal hyperostosis. Case report.

Area of Science:

• Neurology
• Orthopedics
• Spinal Surgery

Background:

• Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition characterized by widespread calcification and ossification of ligaments.
• Neurological complications of DISH are typically associated with spinal stenosis or nerve root compression.
• Cervical myelopathy, a serious spinal cord condition, is an uncommon manifestation of DISH.

Observation:

• A 64-year-old male presented with rapidly progressive cervical myelopathy.
• Radiological imaging identified a partial extradural block.
• Surgical exploration revealed a focal fibrous, calcified mass originating from the ligamentum flavum.

Findings:

• The mass was attributed to focal fibrous proliferation and dystrophic calcification secondary to underlying diffuse idiopathic skeletal hyperostosis (DISH).
• This represents a unique etiology for cervical myelopathy in the context of DISH.
• No prior reports document DISH as a cause of myelopathy via this specific mechanism.

Implications:

• This case expands the spectrum of neurological complications associated with DISH.
• It underscores the importance of considering DISH in the differential diagnosis of cervical myelopathy, even with atypical presentations.
• Further research may elucidate the precise mechanisms linking DISH to focal extradural mass formation and spinal cord compression.