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Dysphagia Caused by Ossification of the Anterior Longitudinal Ligament Associated with Diffuse Idiopathic Skeletal Hyperostosis : report of 2 cases Junichi MIZUNO 1 , Hiroshi NAKAGAWA 1 , Masanori ISOBE 1 1Department of Neurological Surgery, Aichi Medical University Keyword: diffuse idiopathic skeletal hyperostosis , Forestier's disease , ossification of the anterior longitudinal ligament , dysphagia pp.67-72
Published Date 1998/1/10
DOI https://doi.org/10.11477/mf.1436901517
  • Abstract
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Two cases of ossification of the anterior longitudinal ligament (OALL) associated with diffuse idiopathicskeletal hyperostosis (DISH) presenting as dysphagia are reported. DISH has long been regarded as aradiological entity manifesting flowing ossification adjacent to the anterior and lateral borders of at leastfour contiguous vertebral bodies, maintenance of disc spaces, and a dearth of bony ankylosis and erosionof the apophyseal and sacroiliac joints. In the majority of cases, this entity shows an innocuous clinicalcourse, but the dysphagia shown in our cases has also been documented in previous literature. Case 1 wasa 63-year-old male developing progressive dysphagia and rhinolalia. Cervical X-rays and CT showed flow-ing OALL in the entire cervical spine. MRI demonstrated displacement of the trachea and esophagus bythis mass. There was OALL in the thoracic and lumbar spine. Case 2 was a 62-year-old male who hadundergone removal of ossification of the posterior longitudinal ligament (OPLL) from C2 to C5. He deve-loped dysphagia and myelopathy. Cervical X-rays and CT demonstrated projection of OALL as well asposterior osteophytes at C5/6. MRI suggested that OALL, had caused dysphagia, and osteophytes deterio-rated myelopathy. Removal of OALL was carried out in these two cases. In case 2, removal of the osteo-phytes and herniated disc was carried out at the same time. Postoperative course was unremarkable withimprovement of symptoms. Treatment of dysphagia due to OALL is considered to be conservative.However, surgical decompression should be considered in cases of marked projection of OALL obstructingthe esophagus as shown in our cases.


Copyright © 1998, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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