[A case of Forestier's disease causing dysphagia]

Area of Science:

• Spinal Surgery
• Neurology
• Radiology

Background:

• Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis (DISH), is a condition characterized by abnormal bone growth.
• It can affect the cervical spine, leading to potential neurological and functional impairments.

Observation:

• A 52-year-old male presented with dysphagia, hoarseness, and throat clearing, indicative of cervical spine compression.
• Physical examination revealed a neck mass, hyperactive reflexes, and a positive Hoffmann's sign.
• Radiological imaging demonstrated extensive anterior cervical vertebral excrescences (C2-C7), tracheal displacement, esophageal compression, and spinal canal stenosis.

Findings:

• Cervical roentgenogram, CT scans, esophagram, myelogram, and bone scintigraphy confirmed extensive cervical osteophytes causing significant anterior and posterior spinal canal narrowing.
• The patient underwent anterior cervical exploration and osteophyte removal from C3-C7 for decompression of the esophagus and trachea.

Implications:

• Surgical intervention for Forestier's disease causing dysphagia can lead to remarkable symptom improvement.
• This case highlights the importance of considering DISH in the differential diagnosis of cervical myelopathy and dysphagia.