Diffuse idiopathic skeletal hyperostosis with cervical spinal cord injury - A report of 3 cases and a literature review

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.