Diffuse idiopathic skeletal hyperostosis of the cervical spine causing dysphagia and airway obstruction: an updated systematic review

Harlianto, Netanja I; Kuperus, J.; Hoesein, Firdaus A. A. Mohamed; Jong, Pim A. de; Ru, J. Alexander de; Öner, F. Cumhur; Verlaan, Jorrit‐Jan

doi:10.1016/j.spinee.2022.03.002

Cited by 24 publications

(28 citation statements)

References 128 publications

(32 reference statements)

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“…A recent review showed that the total complication rate after surgery was 22.1%, with 12.7% of complications occurring within 1 month after the intervention. 37 Furthermore, Miyamoto et al. 12 reported that 10 to 11 years after the initial surgery for cervical osteophytes, the osteophytes recurred and dysphagia developed in two of seven patients.…”

Section: Discussionmentioning

confidence: 99%

“… 14 , 34 – 36 In an updated systematic review, Harlianto et al. 37 reported that dysphagia with cervical DISH improved in 95.5% of patients following surgical treatment and that earlier surgical intervention was associated with complete resolution of dysphagia in patients with cervical DISH. Surgical treatment was chosen for 66% of patients, with the anterolateral approach most frequently used.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment was chosen for 66% of patients, with the anterolateral approach most frequently used. 37 …”

Section: Discussionmentioning

confidence: 99%

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Head rotation as an effective compensatory technique for dysphagia caused by unilateral cervical osteophytes

Seo

Park

2022

J Int Med Res

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Objective Dysphagia is common in patients with cervical osteophytes. We aimed to determine whether head rotation as a compensatory technique is effective for dysphagia caused by unilateral cervical osteophytes. Methods We retrospectively analyzed videofluoroscopic swallowing study (VFSS) data obtained in one university hospital. Patients whose VFSS showed pharyngeal stasis by mechanical obstruction due to cervical osteophytes were selected. They were divided into a unilateral skewed osteophyte group and a diffuse central osteophyte group as confirmed by laryngoscopy or computed tomography. The effect of head rotation on swallowing was investigated. Fisher’s exact test was used for statistical analysis. Results Among 2876 patients who underwent VFSSs, we identified 48 patients with osteophyte-induced dysphagia. The osteophytes were centrally located in 36 patients and unilateral in the remaining 12. Ten of the patients with unilateral osteophytes showed improvement when they swallowed with head rotation toward the osteophyte side, but none of the patients with central osteophytes showed effective swallowing. A statistically significant relationship was found between swallowing with head rotation and skewed cervical osteophytes. Conclusion Swallowing with head rotation was safe, easy, and effective for patients with dysphagia caused by unilateral cervical osteophytes. We advise attempting this method prior to considering surgical approaches.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Head rotation as an effective compensatory technique for dysphagia caused by unilateral cervical osteophytes

Seo

Park

2022

J Int Med Res

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“…Foristier’s disease, also known as diffuse idiopathic skeletal hyperostosis, is a condition characterised by non-inflammatory ossification of the anterior vertebral longitudinal ligament with the development of osteophytes 1–3. It is mainly observed in men over 50 years of age,2 with a prevalence of 8%–10% over 65 years old 1.…”

Section: Descriptionmentioning

confidence: 99%

Dysphagia as a presentation of DISH

et al. 2023

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“…The exact developmental mechanism for DISH remains undetermined, but a strong metabolic component with low-grade inflammation is likely involved, as DISH is associated with diabetes, obesity and metabolic syndrome [ 2 , 3 ]. DISH may compress structures near the spine, resulting in myelopathy and radiculopathy [ 4 ]. Interestingly, DISH has been identified to be an independent predictor for ischaemic stroke [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Patients with diffuse idiopathic skeletal hyperostosis have an increased burden of thoracic aortic calcifications

Harlianto

Hol

Wittenberg

et al. 2022

Rheumatology Advances in Practice

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Objectives Diffuse idiopathic skeletal hyperostosis (DISH) has been associated with increased coronary artery calcifications and incident ischemic stroke. The formation of bone along the spine may share pathways with calcium deposition in the aorta. We hypothesized that patients with DISH have increased vascular calcifications. Therefore, we aimed to investigate the presence and extent of DISH in relation to thoracic aortic calcifications (TAC) severity. Methods This cross-sectional study included 4703 patients from the Second Manifestation of ARTerial disease cohort consisting of patients with a cardiovascular events or risk factors for cardiovascular disease. Chest radiographs were scored for DISH using the Resnick criteria. Different severities of TAC were scored arbitrarily from no TAC to mild, moderate, and severe TAC. Using multivariate logistic regression, the associations between DISH and TAC were analyzed with adjustments for age, sex, body mass index, diabetes, smoking status, non-HDL cholesterol, renal function, and blood pressure. Results A total of 442 patients (9.4%) had evidence of DISH and 1789 (38%) patients had TAC. The prevalence of DISH increased from 6.6% in the no TAC to 10.8% in the mild, 14.3% in the moderate, and 17.1% in the severe TAC group. After adjustments, DISH was significantly associated with the presence of TAC (OR 1.46; 95%CI:1.17-1.82). In multinomial analyses, DISH was associated with moderate TAC (OR: 1.43; 95%CI:1.06-1.93) and severe TAC (OR: 1.67; 95%CI:1.19-2.36). Conclusions Subjects with DISH have increased TAC, providing further evidence that patients with DISH have an increased burden of vascular calcifications. Lay summary What does this mean for patients? Diffuse idiopathic skeletal hyperostosis (DISH) is a common condition of the spine characterized by the formation of new bone and the fusion of spinal segments. Patients with DISH have a large heart disease burden, as DISH has been associated with high blood pressure, a high body mass index (BMI), and the presence of diabetes. Recently, a large study found that patients with DISH have an increased risk for developing ischemic strokes. Ischemic strokes typically occur when a blood clot forms as a result of blocked arteries. The blood clot then prevents flow of oxygen and blood to the brain. The exact cause of the association between DISH and ischemic strokes is still unknown. We studied the severity of vascular calcification in the aorta in the same group of patients as the previous study. Vascular calcifications are mineral deposits in blood vessels which can stick to fatty deposits and increase risk of stroke. We found that DISH is associated with more severe vascular calcification in the aorta, which may explain the relation with strokes. We provide further evidence for DISH as a marker for heart disease and highlight the importance of heart disease prevention in patients with DISH.

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Diffuse idiopathic skeletal hyperostosis of the cervical spine causing dysphagia and airway obstruction: an updated systematic review

Cited by 24 publications

References 128 publications

Head rotation as an effective compensatory technique for dysphagia caused by unilateral cervical osteophytes

Head rotation as an effective compensatory technique for dysphagia caused by unilateral cervical osteophytes

Dysphagia as a presentation of DISH

Patients with diffuse idiopathic skeletal hyperostosis have an increased burden of thoracic aortic calcifications

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