Use of ultrasonic bone dissector in diffuse idiopathic skeletal hyperostosis involving the cervical spine.

Abstract

Introduction and importance: Diffuse idiopathic skeletal hyperostosis (DISH), or Forestier's disease, is characterized by ligament and enthesis calcification, mainly in the thoracic spine. Cervical involvement can cause dysphagia due to soft tissue compression, necessitating surgical intervention when conservative measures fail. We assess the efficacy of anterior cervical osteophytectomy with an ultrasonic bone dissector in relieving symptoms and improving outcomes.

Case presentation: A 73-year-old male presented with progressive neck pain and dysphagia caused by DISH in the cervical spine. Conservative treatment was ineffective, requiring anterior cervical osteophytectomy using an ultrasonic bone dissector. Postoperative imaging confirmed spinal cord decompression, and the patient experienced significant symptom relief. The ultrasonic bone dissector enabled precise bone resection, facilitating resolution of dysphagia and improving quality of life.

Clinical discussion: This case highlights the effectiveness of ultrasonic bone dissection for cervical DISH. The device ensures precise bone removal with minimal soft tissue trauma, reducing complications and promoting recovery. While initial outcomes are promising, long-term studies are needed to compare this method with other interventions.

Conclusion: Surgical intervention, particularly anterior cervical osteophytectomy with ultrasonic bone dissection, is effective when conservative treatments fail. Advanced surgical techniques improve patient outcomes and warrant further investigation to establish their role in managing cervical DISH.