What are the possible complications of diffuse idiopathic skeletal hyperostosis (DISH)?

Updated: Oct 23, 2018
  • Author: Bruce M Rothschild, MD; Chief Editor: Jeffrey D Thomson, MD  more...
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Answer

Overgrowth of ligamentous calcification could impinge on other structures (eg, the esophagus). Reports of this are rare and often represent inadvertently discovered, neurologically mediated swallowing deficits. [40, 41]

Posterior longitudinal ligament ossifications may impinge on the spinal cord on rare occasions.

Reduced vertebral column flexibility predisposes to vertebral fracture. Vertebral fracture risk (cervical, 60%; thoracic, 34.5%; lumbar, 5.5%) is inherent with an ankylosed hyperostotic vertebral column from minor trauma, preoperative and postoperative positioning, or intraoperative maneuvers (eg, retroperitoneal or hip replacement surgery). [3, 42, 43] Note that as well as with fully ankylosed spines, partially ankylosed spines also are at risk, with fractures occurring adjacent to the fused regions. [44] The risk of fracture increases with the number of vertebra ankylosed. [45] Obesity is an additional risk factor for fracture, [28] overstressing the already at-risk spine.


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