Abstract
We experienced 2 cases of spinal fracture in patients aged 80 years or older with diffuse idiopathic skeletal hyperostosis (DISH). Since they decided not to undergo surgical treatment, we provided conservative treatment with teriparatide. There has been no previous study on teriparatide for spine fracture in DISH. This is the first report of the successful use of teriparatide to treat spine fracture in DISH without surgical intervention. Our patients were treated with teriparatide for 8-9 months after diagnosis of the fracture. Union was obtained in two cases and no adverse events were observed during treatment. Our report showed that teriparatide could be an alternative to conventional intervention in spinal fracture of DISH.
Highlights
Patients with diffuse idiopathic skeletal hyperostosis (DISH) may experience problems in that spinal bone fractures can occur in response to slight external forces
We experienced 2 cases of spinal fracture in patients aged 80 years or older with diffuse idiopathic skeletal hyperostosis (DISH). Since they decided not to undergo surgical treatment, we provided conservative treatment with teriparatide
For bone fractures that occur in patients with ankylosing spinal disorders (ASD), such as ankylosing spondylitis (AS) and DISH, surgical treatment is recommended rather than conservative treatment, based on the results of analyses of the incidence of complications and prognosis [1]
Summary
Patients with diffuse idiopathic skeletal hyperostosis (DISH) may experience problems in that spinal bone fractures can occur in response to slight external forces. In such bone fractures, it is difficult to ensure that bone union is achieved with conservative treatment, as seen in transverse fracture of a long bone. We report our experience of 2 cases, in which bone union was achieved by using conservative treatment with teriparatide, enabling walking with no lumbar pain For these cases, we did not select surgical treatment because the patients were among extreme old age and had various medical comorbidities
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