嚥下障害をきたした強直性脊椎骨増殖症の1例

Ankylosing Spinal Hyperostosis with Dysphagia:A Case Report

　はじめに

　強直性脊椎骨増殖症（Ankylosing spinal hyperostosis；ASH）はForestier病とも呼称される疾患であり，広範な靱帯骨化をきたす。その主病変である前縦靱帯骨化により臨床症状が出現することは従来まれといわれていたが^1,2），今回われわれは本症により嚥下時違和感と誤嚥を訴え，観血的治療により症状の消失した1例を経験したので報告する。

Ankylosing spinal hyperostosis (ASH), or Fores-tier's disease, with dysphagia was found in a 71-year-old man who complained of dysphagia of 1 month's duration. Fiberscopic examination showed a wide swelling of the posterior wall of the pharynx, and a displacement of the left pyriform sinus which was not able to be observed by this swelling. Mucosal surface of the pharynx, however, showed no sign of inflammatory or tumorous lesion. X-ray examination revealed a wide ossification of the anterior longitudinal ligament (OALL) of the cer-vical spines (C2-C7). Esophagogram showed a dis-placement of the cervical esophagus and misswall-owing of barium to the trachea.

Surgery was performed by anterior approach to the spines, and osteophytes from C3 to C6 were removed.

Postoperative course was uneventful and his symptoms were disappeared.