Clinical and radiographic manifestations of anterior cervical osteophytes: Case series report

Abstract

Anterior cervical osteophytes are a common but underdiagnosed systemic condition [1]. They can occur in degeneration of the cervical spine or in diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease. It was first described by Forestier and Rotes-Querol in 1950 [2]. The defining criteria for DISH require flowing anterolateral ossifications of at least four contiguous vertebral segments, preservation of the intervertebral disc spaces and absence of apophyseal joint degeneration or sacroiliac inflammatory changes [3,4]. Most patients with anterior cervical osteophytes are either asymptomatic or have limited cervical spine movement and unspecified pain, but possible complications are sometimes to meet with dysphagia, dyspnea, dysphonia, ossification of the posterior longitudinal ligament or myelopathy, aspiration pneumonia, sleep apnea, thoracic outlet syndrome and intubation difficulties or endoscopic problems [5,6]. Treatment of DISH-associated dysphagia or respiratory compromise depends on the severity of disease. In patients for whom medical management fails and those with respiratory complaints, surgical intervention is indicated. Access, adequate exposure, and removal of significant bony volume is best managed via a transcervical approach [7,8]. Reported complications include recurrent laryngeal paralysis, stroke, Horner syndrome, haemaA R T I C L E I N F O