Diffuse Idiopathic Skeletal Hyperostosis Involving Cervical and Lumbar Spine Presenting with Dysphagia: A Case Report

Document Type : Case Report


1 Department of Otorhinolaryngology, Medical College, Kolkata, India.

2 Senior Divisional Medical Officer, B R Singh Hospital (Eastern Railways), Kolkata, India


Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a very rare cause of dysphagia when it occurs in the cervical spine. It can also affect the lumbar region where it causes deformity.
Case Report:
In this article, a rare case of Diffuse Idiopathic Skeletal Hyperostosis involving both the cervical and lumbar spine, presenting with dysphagia and spinal stiffness leading to a stooping posture, is reported.
Cases of simultaneous involvement of cervical and lumbar vertebrae by Diffuse Idiopathic Skeletal Hyperostosis, presenting with symptoms of both area involvement, are rarely reported in the English literature. When investigating a case of dysphagia, a high level of suspicion is required to diagnose such a condition.


Main Subjects

1. Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis. 1950; 9(4):321–30.
2. Resnick D, Niwayama G. Radiographic and pathological features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH) Radiology. 1976;119(3):559–68.
3. Miyamoto K, Sugiyama S, Hosoe H, Iinuma N, Suzuki Y, etal. Postsurgical recurrence of ost- eophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis. European Spine Journal, 2009; 18(11), 1652–8.
4. Smart R, Ghali GE. Dysphagia caused by diffuse idiopathic skeletal hyperostosis. J Oral Maxillofac Surg. 2016;74(4):764-69.
5. Holton KF, Denard PJ, Yoo JU, Kado DM, Barrett-Connor E, Marshall LM. Osteoporotic Fractures in Men (MrOS) Study Group. Diffuse idiopathic skeletal hyperostosis and its relation to back pain among older men: The MrOS study. Semin Arthritis Rheum. 2011; 41(2):131–8.
6. Carlson MJ, Stauffer RN, Spencer Payne W. “Ankylosing vertebral hyperostosis causing dysphagia” Archives of Surgery,1974;109(4):567-70.
7. Paley D, Schwartz M, Cooper P. Fractures of the spine in diffuse idiopathic skeletal hyperostosis.Clin Orthop.1991;267:22–32.
8. Iglauer S. A case of dysphagia due to an osteochondroma of the cervical spine-osteotomy-recovery. Ann Otol.1938;47(3):799–803.
9. Johnsson KE, Petersson H, Wollheim FA. Diffuse idiopathic skeletal hyperostosis causing spinal stenosis and sudden paraplegia. J Rheumatol. 1983; 10(5):784–9.
10. Lambert JR, Tepperman PS, Jimenez J, Newman A. Cervical spine disease and dysphagia: Four new cases and a review of the literature. Am J Gastroenterol. 1981;76(1):35–40.
11. Dutta S, Biswas KD, Mukherjee A, Basu A, Das S, Sen I, et al. Dysphagia Due to Forestier Disease: Three Cases and Systematic Literature Review. Indian Journal of Otolaryngology and Head and Neck Surgery. 2014;66(Suppl 1):379-84.
12. Kos MP, Van Royen BJ, David EF, Mahieu HF. Anterior cervical osteophytes resulting in severe dysphagia and aspiration: two case reports and literature review. J Laryngol Otol. 2009; 123(10): 1169-73.