Korean J Spine.  2013 Sep;10(3):200-202. 10.14245/kjs.2013.10.3.200.

Giant Anterior Cervical Osteophyte Leading to Dysphagia

Affiliations
  • 1Department of Neurosurgery, Yeouido St. Mary's Hospital, Catholic University of Korea, Korea. joowonil4858@gmail.com

Abstract

Large anterior cervical osteophytes can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis(DISH). Large osteophytes can produce otolaryngological symptoms such as dysphagia, dysphonia, and foreign body sensation. We describe a DISH patient with giant anterior cervical osteophyte causing chronic dysphagia and dysphonia. A 56-year-old man presented with increasing dysphagia, dysphonia, neck pain and neck stiffness. Physical examination of the neck showed a non-tender and hard mass on the left side at the level of C4-5. Radiography showed extensive ossification of anterior longitudinal ligament along the left anterolateral aspect of vertebral bodies from C2 to T1. The ossification was espe cially prominent at the level of C4-5 and linear breakage was noted at same level. Esophagogram revealed a filling defect along the pharynx and lateral displacement of the esophagus. Giant anterior cervical osteophyte was removed through the leftsided anterolateral cervical approach to the spine. Anterior cervical interbody fusion at C4-5 was followed by posterior cervical fixation using lateral mass screws from C3 to C6. After surgery, dysphagia and dysphonia improved immediately. One year later, cervical CT showed bone fusion at C4-5 bodies and no recurrence of osteophyte. DISH is a common cause of anterior cervical osteophyte leading to progressive dysphagia. Keeping this clinical entity in the differential diagnosis is important in patients with progressive neck stiffness, dysphagia or dysphonia. And surgical treatment of symptomatic anterior cervical osteophyte due to DISH should be considered with a solid fusion procedure preventing postoperative instability or osteophyte progress.

Keyword

Anterior cervical osteophyte; Diffuse idiopathic skeletal hyperostosis; Dysphagia; Dysphonia

MeSH Terms

Deglutition Disorders*
Diagnosis, Differential
Dysphonia
Esophagus
Foreign Bodies
Humans
Hyperostosis, Diffuse Idiopathic Skeletal
Longitudinal Ligaments
Middle Aged
Neck
Neck Pain
Osteophyte*
Pharynx
Physical Examination
Recurrence
Sensation
Spine
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