ArticleJournal of orthopaedic case reports2026
Severe Aerodigestive Compromise Caused by Cervical Diffuse Idiopathic Skeletal Hyperostosis: A Case Report.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory enthesopathic disorder characterized by flowing ossification along the spine. Cervical involvement may compress the aerodigestive tract, causing dysphagia, aspiration risk, and malnutrition. Case Report: An 82-year-old male presented with 9 months of progressive dysphagia and odynophagia, eventually intolerant even of liquids, with ~10 kg weight loss. Radiographs demonstrated flowing anterior ossification from C2 to C7; barium swallow confirmed bolus hold-up at C5-C6; computed tomography (CT) revealed bulky ventral osteophytes; magnetic resonance imaging (MRI) excluded myelopathy. Following failed conservative management, anterior cervical osteophytectomy (C3-C7) was performed. Objective outcomes measured pre-operative, at 1 month post-operative, and at 2-year follow-up improved from Functional Oral Intake Scale 2 → 6 → 7, Eating Assessment Tool-10 32 → 8 → 2, M.D. Anderson Dysphagia Inventory global 48 → 86, and Prevertebral Soft Tissue 2.6 mm → 5.1 mm → 3.9 mm, with full dietary normalization and no recurrence at 2-year follow-up. Discussion: The diagnostic pathway (radiographs → barium swallow → CT ± MRI) aligns with commonly recommended approaches for evaluating mechanical dysphagia. Surgical osteophytectomy is highly effective, with ~95% improvement and ~4% symptomatic recurrence reported in systematic reviews. Conclusion: Timely recognition and osteophytectomy for severe cervical DISH can restore complete functional swallowing, objectively verified across validated outcome measures, with durable remission at 2 years.
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