Diffuse Idiopathic Skeletal Hyperostosisによる頸椎前面の異常骨棘形成から嚥下障害をきたした1例

A Case of Diffuse Idiopathic Skeletal Hyperostosis (DISH) Causing Dysphagia

I．はじめに

　嚥下困難を生じる原因には内科的に種々のものが知られているが，頸椎前方骨棘が食道を外側から圧迫することによって生ずるものは比較的に稀^{2,5,6,11-13）}とされている．また，われわれ脳神経外科医の立場から経験する脊椎の退行性変化に由来する様々な症状の中で，嚥下障害は経験する機会の比較的少ないものである．

　最近，われわは頸椎前面に生じた異常骨棘によって嚥下障害をきたした1例を経験したので文献的考察を加え報告する．

A case of diffuse idiopathic skeletal hyperostosis caus-ing dysphasia was reported. A 62 year-old man was admitted to our hospital complaining of nuchal pain and dysphagia. Roentgenograms of the cervical spine demon-strated a “flowing” ossification anterior to three con-tiguous vertebral bodies, C4-6.

Esophagraphic examination demonstrated esophageal compression caused by the enormous ossification. Roent-genograms of the thoracic and lumbar spine revealed an anterior bony bridge and prediscal ossicles at multiple levels of the vertebral column. These radiographic fea-tures were characteristic of DISH. The authors discussed the symptomatology, differential diagnosis and treat-ment of DISH mainly involving the cervical region, and emphasized the importance of being able to recog-nize this unfamiliar disorder in the neurosurgical clinic.