Introduction: Diffuse idiopathic skeletal hyperostosis (DISH), though common, is often asymptomatic. However, spinal hyperostosis can predispose the affected to chronic myelopathic symptoms and acute spinal cord injury. Clinical Picture: We report on 3 patients with DISH, who sustained traumatic cervical cord injuries. Two were tetraplegic at presentation. The radiologic findings of the patients are also discussed. Treatment: Both the tetraplegic patients were treated non-surgically in view of high surgical risk. Outcome: Both the tetraplegic patients died due to mechanical respiratory failure. Conclusions: The potential catastrophic neurological sequelae of DISH from relatively minor trauma must be understood. Further studies are needed to aid in evidence-based clinical management of asymptomatic patients with DISH.
Despite being a largely asymptomatic clinical condition, diffuse idiopathic skeletal hyperostosis (DISH) has been widely described in literature due to its often-interesting clinical manifestations. Here we describe 3 case reports of spinal cord injuries in patients with DISH who presented to Tan Tock Seng Hospital, Singapore, between March 2000 and April 2004. We also include a review of the diagnosis, epidemiology and common mechanisms of cord injury in DISH.
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