Minimally Invasive Approach for Diffuse Idiopathic Skeletal Hyperostosis (DISH)-Related Vertebral Fractures: A Case Report on Combining Vertebral Cement Augmentation and Cement-Augmented Pedicle Screw Instrumentation.

Abstract

Diffuse idiopathic skeletal hyperostosis (DISH)-related vertebral fractures often require surgical intervention due to associated spinal instability and neurological deficits. This study presents a minimally invasive approach that utilizes vertebral cement augmentation and cement-augmented pedicle screw (PS) instrumentation to manage DISH-related vertebral fractures. We present an 87-year-old male patient with a T11 vertebral fracture associated with DISH. Despite the patient's advanced age and comorbidities, he underwent a successful surgical procedure, achieving relatively short-segment fixation by combining vertebral cement augmentation and cement-augmented PS instrumentation. After the surgery, the patient's lower back pain subsided, facilitating a return to normal activities. Radiographic evaluation at the six-month postoperative stage confirmed the maintenance of vertebral body reduction with no indications of implant failure. In DISH-associated vertebral fractures, the combined application of vertebral cement augmentation and cement-augmented PS instrumentation offers a minimally invasive solution that expedites fracture stabilization and enhances patient outcomes. This approach offers the potential for effective fracture stabilization and a significant reduction in postoperative complications, holding promise for managing challenging cases in this patient population.