Two different causes of acute respiratory failure in a patient with diffuse idiopathic skeletal hyperostosis and ankylosed cervical spine

Vengust, Rok; Mihalič, René; Turel, Matjaž

doi:10.1007/s00586-009-1159-6

Cited by 23 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…DISH also involves calcifications in the entheses of extra‐spinal tendons and ligaments (e.g., olecranon ligaments, patellar ligament, and Achilles tendon attachment to the calcaneus) . DISH often manifests as back pain and stiffness; however, surrounding anatomical structures can be affected leading to dysphagia, airway obstruction, or compression of the spinal cord and nerve roots . The ectopic calcifications associated with DISH are also associated with an increased risk of spinal fractures as well as postsurgical heterotopic calcifications…”

mentioning

confidence: 99%

Ectopic spinal calcification associated with diffuse idiopathic skeletal hyperostosis (DISH): A quantitative micro‐ct analysis

Fournier

Norley

Pollmann

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

Diffuse idiopathic skeletal hyperostosis (DISH) is a non‐inflammatory spondyloarthropathy identified radiographically by calcification of the ligaments and/or entheses along the anterolateral aspect of the vertebral column. The etiology and pathogenesis of calcifications are unknown, and the diagnosis of DISH is currently based on radiographic criteria associated with advanced disease. To characterize the features of calcifications associated with DISH, we used micro‐computed tomographic imaging to evaluate a cohort of 19 human cadaveric vertebral columns. Fifty‐three percent of the cohort (n = 10; 3 females, 7 males, mean age of death = 81 years, range 67–94) met the radiographic criteria for DISH, with calcification of four or more contiguous vertebral segments. In almost all cases, the lower thoracic regions (T8‐12) were affected by calcifications, consisting primarily of large, horizontal outgrowths of bony material. In contrast, calcifications localized to the upper thoracic regions demonstrated variability in their presentation and were categorized as either “continuous vertical bands” or “discontinuous‐patchy” lesions. In addition to the variable morphology of the calcifications, our analysis demonstrated remarkable heterogeneity in the densities of calcifications, ranging from internal components below the density of cortical bone to regions of hyper‐dense material that exceeded cortical bone. These findings establish that the current radiographic criteria for DISH capture heterogeneous presentations of ectopic spine calcification that can be differentiated based on morphology and density. These findings may indicate a naturally heterogenous disease, potential stage(s) in the natural progression of DISH, or distinct pathologies of ectopic calcifications. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

show abstract

mentioning

confidence: 99%

Ectopic spinal calcification associated with diffuse idiopathic skeletal hyperostosis (DISH): A quantitative micro‐ct analysis

Fournier

Norley

Pollmann

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…We have reviewed 67 studies reported in the literature of the past 25 years, which include patients with symptomatic ACOs treated by this approach. [ 11 12 13 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 ] Nineteen studies[ 29 30 34 38 39 49 50 51 54 56 62 …”

Section: Discussionmentioning

confidence: 99%

Anterior cervical osteophytes causing dysphagia: Choice of the approach and surgical problems

Maiuri¹,

Cavallo²,

Corvino³

et al. 2020

J Craniovert Jun Spine

View full text Add to dashboard Cite

Background: Anterior cervical osteophytes (ACOs) may rarely cause dysphagia, dysphonia, and dyspnea. Symptomatic ACOs are most commonly located between C3 and C7, whereas those at higher cervical (C1–C2) levels are rarer. We report a case series of 4 patients and discuss the best surgical approach according to the ostheophyte location and size, mainly for those located at C1–C2, and the related surgical problems. Materials and Methods: Four patients (two males and two females) aged from 57 to 72 years were operated on for ACOs, causing variable dysphagia (and dyspnea with respiratory arrest in one). Three patients with osteophytes between C3 and C5 were approached through antero-lateral cervical approach, and one with a large osteophyte between C1 and C3–C4 level underwent a two-stage transcervical and transoral approach. All had significant postoperative improvement of dysphagia. Results: The patient operated on though the transoral approach experienced postoperative flogosis of the prevertebral tissues and occipital muscles and thrombosis of the right jugular vein and transverse-sigmoid sinuses (Lemierre syndrome). Conclusion: The transoral approach is the best surgical route to resect C1 and C2 ACOs, whereas the endoscopic endonasal approach is not indicated. The anterior transcervical approach is easier to resect osteophytes at C3, as well as those located below C3. A combined transoral and anterior cervical approach may be necessary for multilevel osteophytes.

show abstract

“…Vengust et al described a patient with diffuse idiopathic skeletal hyperostosis who presented initially with massive osteophytes compressing the trachea at C7–T1, and later by a C3–C4 fracture dislocation causing laryngeal nerve entrapments with vocal cord paresis. 17 Severe dyspnea can also occur by combination of cervical spondylosis and goiter. Woischneck et al described a 79-year-old woman with the coincidence of goiter and ventral cervical spondylopathy accompanied by severe dyspnea.…”

Section: Discussionmentioning

confidence: 99%

Dyspnea as the Presenting Symptom of Cervical Spondylotic Myelopathy

Yu¹,

Romero²,

Miles

et al. 2016

Surg J

View full text Add to dashboard Cite

Background A case report of acute unilateral hemidiaphragm paralysis and resultant dyspnea due to cervical spondylotic myelopathy (CSM) is described. Case Report An 82-year-old man presented with a nonproductive cough, chest congestion, hoarseness, and shortness of breath on ambulation. The patient underwent cardiac catheterization, which revealed extensive stenosis of the major cardiac arteries. Subsequently, he underwent triple coronary artery bypass grafting. Despite the cardiac surgery, the patient's dyspnea did not improve. In addition, he developed new complaints of generalized weakness. Magnetic resonance and radiographic imaging of the cervical spine revealed extensive multilevel degenerative spondylosis with moderate to severe central canal narrowing from C2 to C7 and myelomalacia. The patient underwent C2–C6 laminectomy and instrumented fusion with local autograft. After surgery, the patient had gradual relief of dyspnea as well as improvement of strength. The dyspnea completely resolved. Conclusion The diagnosis of CSM as the cause of dyspnea is difficult to make. When unrelated cardiac or pulmonary disease coexists, the presenting symptoms of CSM may be subtle and must be actively sought. Signs and symptoms can vary widely and may include symptoms of intermittent neck pain or headache. Dyspnea may be related to unilateral diaphragm paralysis caused by CSM. This etiology of dyspnea should be considered in elderly patients who have other comorbidities that often obscure the diagnosis.

show abstract

Two different causes of acute respiratory failure in a patient with diffuse idiopathic skeletal hyperostosis and ankylosed cervical spine

Cited by 23 publications

References 12 publications

Ectopic spinal calcification associated with diffuse idiopathic skeletal hyperostosis (DISH): A quantitative micro‐ct analysis

Ectopic spinal calcification associated with diffuse idiopathic skeletal hyperostosis (DISH): A quantitative micro‐ct analysis

Anterior cervical osteophytes causing dysphagia: Choice of the approach and surgical problems

Dyspnea as the Presenting Symptom of Cervical Spondylotic Myelopathy

Contact Info

Product

Resources

About