弥漫性特发性骨肥厚症继发吞咽困难1例

正弥漫性特发性骨肥厚症(diffuse idiopathic skeletal hyperostosis,DISH)多发于老年男性~([1]),国外文献报道发病率为2.9%~28%~([1~3])。累及颈椎的DISH的病理特点为颈椎相关韧带钙化、骨质增生~([4]),严重者可出现脊柱强直、骨折、声音嘶哑、呼吸或吞咽困难等。该疾病国内报道不多,笔者手术治愈因弥漫性特发性骨肥厚症累及颈椎所致严重吞咽困难1例,取得较满意的临床疗效,报道如下。     

颈椎弥漫性特发性骨肥厚症的特点和治疗

弥漫性特发性骨肥厚症（diffuse idiopathic skeletal hyperostosis，DISH）是一种常见的随年龄增长而逐渐增多的疾病。目前国内流行病学资料匮乏，国外资料显示在超过40岁的人群中，男性发病率为3．8％，而女性为2．6％；在65岁以上人群中的发生率约为10．0％。大多数颈椎DISH并不引起症状;少数颈椎DISH可产生了一系列特殊临床症状．已引起学者的重视。     

弥漫性特发性骨肥厚症研究进展

弥漫性特发性骨肥厚症(DISH)是一种以韧带和肌腱附着点的骨化、钙化为特征的全身性疾病,多见于老年男性。Forestier等^[1]于1950年首次描述了该病,并将其描述为"老年强直性脊椎骨肥大",亦称为Forestier病。20世纪70年代,Resnick等^[2]归纳总结了Forestier病的影像学和病理学特点,正式将其命名为DISH。DISH常累及椎旁韧带,多见于胸椎,其次是颈椎和腰椎^[3]。周围关节(如肩、肘、腕、骨盆、髋、膝和脚踝)也可发生软组织增厚和钙化^[4]。DISH缺乏特征性的临床症状,多局限于影像学表现,其诊断容易被忽略。本文通过查阅DISH相关文献,从流行病学、发生机制、临床表现、影像学表现、诊断和治疗等方面展开分析,以期为DISH的临床诊治提供参考,综述如下。     

弥漫性特发性骨肥厚症并不完全性脊髓损伤1例报告

<正>弥漫性特发性骨肥厚症（DISH）是一种以脊柱前外侧韧带钙化或骨化为特征的骨骼疾病,可累及全脊柱乃至全身骨骼,有研究[1]显示,其好发于中老年人群,男性较女性更为多见。DISH合并颈椎后纵韧带骨化症（OPLL）临床并不少见,但外伤后出现脊髓损伤症状的报道不多,现将本院收治的1例DISH并不完全性脊髓损伤患者的治疗情况报告如下。     

颈胸椎弥漫性特发性骨肥厚症合并后纵韧带骨化症1例报告

<正>弥漫性特发性骨肥厚症(diffuse idiopathic skeletal hyperostosis, DISH)是中老年人常见骨骼疾病,主要累及脊柱,特征是大量表浅的不规则椎体前和侧缘骨质增生相互融合形成椎体前广泛肥厚骨块,又称强直性骨肥厚^[1-2]或Forestier病。     

弥漫性特发性骨肥厚症的概念与临床特征

临床上，弥漫性特发性骨肥厚症并不少见，常因为缺乏对本病的认识忽视了进一步全面检查，而将这种疾病的某些局部的影像表现就简单地列为颈椎和胸腰椎退变性疾病，并加以诊断和治疗。其实质，本病是全身病变，而又以脊柱为集中表现的一种连续多个节段椎体前侧方异位骨化的特殊类型的疾病。早在50多年前，Forestier首先报告了以脊柱前侧缘骨化为特征、     

弥漫性特发性骨肥厚症（DISH）的手术治疗

报告２８例弥漫性特发性骨肥厚症（ＤＩＳＨ），其中２７例伴有脊髓病或神经根病，１例伴有食道压迫症。全部病例均进行了手术治疗。ＤＩＳＨ伴有颈脊髓压迫的手术优良率为８３．３％；伴有胸脊髓压迫的手术优良率为６６％。对手术治疗有关的问题进行了讨论。     

胸腰椎过伸骨折合并弥漫性特发性骨肥厚症的临床研究

目的分析合并弥漫性特发性骨肥厚症(DISH)胸腰椎过伸骨折的损伤机制、损伤特点,以指导治疗方案的选择。方法回顾性分析自2007-01—2015-12诊治的95例合并DISH胸腰椎过伸骨折,根据X线片、CT及MRI评估脊柱损伤类型:前柱经椎间盘损伤44例(46.3%),经骨损伤41例(43.2%),混合型损伤10例(10.5%)。所有患者均行脊柱后路切开复位椎弓根钉内固定手术治疗。结果术后3例出现切口愈合不良,给予换药、抗生素治疗后痊愈。术后X线片显示8枚椎弓根钉位置不佳。在治疗期间,4例出现贫血,5例出现全身炎症性反应综合征(SIRS),4例抗甲氧西林金黄色葡萄球菌感染(MRSA),5例肺或肾脏衰竭,2例肺部感染,1例泌尿系感染,1例出现褥疮。4例在创伤后3个月内死亡,死亡患者年龄75~88(81.7±4.1)岁。结论随着高龄人口及脊柱代谢疾病的增多,DISH患者中出现的胸腰椎过伸损伤也会随之增加。临床骨科医师要充分认识合并DISH胸腰椎过伸骨折的特点,以便制定较为合理的治疗方案。     

以腰背痛为主要症状的弥漫性特发性骨肥厚误诊为脊柱关节炎1例

<正>1病例资料患者,男,52岁。2012年6月出现无明显诱因的腰痛、活动受限,腰背痛时轻时重,晨起与夜间加重,活动及受凉后加重,休息后略有缓解,无皮疹、眼炎,无腹泻、足跟痛、咽痛、雷诺现象及动物接触史,无脊柱关节炎家族史,无明显消瘦。2013年1月患者来辽宁中医药大学附属医院就诊,查骶髂关节CT示双侧骶髂关节关节面毛糙,部分关节面融合,关节间隙局部狭窄、消失,双侧髂骨     

强直性脊柱炎合并弥漫性特发性骨肥厚腰椎术后翻修一例

目的 强直性脊柱炎(AS)和弥漫性特发性骨肥厚(DISH病)均为脊柱强直性疾病,二者同时发生临床极为少见,同时合并腰椎管狭窄目前国内尚无报道,我们遇到1例初次手术失败的此诊断的病人,通过分析此例病例的特点,回顾文献,提高临床医生对此类少见的疾病认识和诊疗水平.方法 收集此例病人初次手术前后及随访时的临床及影像资料,结合...     

A paleoepidemiologic study of diffuse idiopathic skeletal hyperostosis

OBJECTIVE: To investigate the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in ancient populations. MATERIAL AND METHODS: We studied 38 women and 61 men aged at least 30 years at death, whose remains were recovered from four cemeteries of the High Middle Ages (VIth to VIIIth century) located in Lorraine (eastern France). Criteria previously developed by Crubézy and Crubézy-Ibanez for paleopathological studies were used to determine whether the skeletal remains exhibited definite, possible, probable, or no DISH. RESULTS: Definite DISH with flowing ossification along the thoracic spine and ossification of peripheral enthesopathies was seen in 2.8 to 3.7% of the subjects from two cemeteries and in none from the other two cemeteries. Identical figures were found for possible DISH. The prevalence and male predominance s (nine of 13 subjects in any DISH category were males) were similar to those reported in contemporary studies and in other paleopathological studies. CONCLUSION: In the absence of clinical data on the metabolic status of the study subjects, our results suggest that DISH in our subjects was a marker for older age at death.     

Cervical myelopathy in diffuse idiopathic skeletal hyperostosis. Case report

The case of a rapidly progressive cervical myelopathy in a 64-year-old man is presented. Radiological studies revealed a partial extradural block, which at surgery was found to be a focal fibrous, calcified mass associated with the ligamentum flavum. On the basis of the underlying disorder of diffuse idiopathic skeletal hyperostosis (DISH), the etiology of this compression was concluded to be focal fibrous proliferation and dystrophic calcification. The neurological complications of DISH are reviewed. The authors are not aware of any other reports of this cause of myelopathy associated with DISH.     

Myelopathy and radiculopathy in diffuse idiopathic skeletal hyperostosis

Thirty-four patients of diffuse idiopathic skeletal hyperostosis (DISH) were presented. Twenty-four of them were associated with myelopathy or radiculopathy, mainly due to spinal stenosis. Plain X-ray films showed there was spinal flowing or laminated ossification on the anterior or right lateral side, forming continuous bony bridge at least of four vertebral bodies. Ossification occurred both on the spinal and extra-spinal region. Operative findings of 11 cases revealed significant encroachment of the ossified mass on the dural sac, especially at the level of the apophyseal joint. OPLL was found in ten cases. DISH and OPLL may be different manifestations of same entity. In this series, there was not enough evidence of diabetes mellitus related to DISH, and no specific antigen in HLA typing.