Thoracolumbar Fracture in Disseminated Idiopathic Skeletal Hyperostosis

Disseminated idiopathic skeletal hyperostosis (DISH) is a form of ankylosing spinal disorders, which is at high risk of fracture because of the rigidity of the spinal column and reduced bone quality. The patients with DISH are at higher risk of fall because of the poor muscle tone, rigid spine column, and positive sagittal balance. The management of spinal fractures in these patients proves to be challenging because of the altered biomechanics and alignment of the spine. Furthermore, most patients have multiple comorbidities with high intraoperative burden, and osteoporosis itself will impair any implant purchase of the bone. Here, we report a case of thoracolumbar fracture in DISH where both conservative and surgical approaches were utilized, with unfortunate results in both, and a brief review of the literature on its management.