Foreatiers disease is a peculiar type of ankylosing hyperostosis of the spine characterized by ossification of the anterior and right lateral aspects of the vertebral column, particularly in the thoracic region. The clinical, pathological and reontgenographic features of the disorder allowed its differentiation from other spinal diseases including ankylosing spordylitis and osteoarthritis. A case of Forestiers disease is presented with brief review of literatures.
Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal ; Osteoarthritis ; Spinal Diseases ; Spine

Diffuse idiopathic skeletal hyperostosis (DISH) is a disease characterized by massive, non-inflammatory ossification with intensive formation of osteophytes affecting ligaments, tendons, and fascia of the anterior part of the spinal column, mostly in the middle and lower thoracic regions. However, isolated and predominant cervical spinal involvement may occur. It has predilection for men (65%) over 50 years of age and a prevalence of approximately 15-20% in elderly patients.1 A CT scan is one of the diagnostic tools. The radiographic diagnostic criteria in the spine include: 1) osseous bridging along the anterolateral aspect of at least four vertebral bodies; 2) relative sparing of intervertebral disc heights, with minimal or absent disc degeneration; and 3) absence of apophyseal joint ankylosis and sacroiliac sclerosis.2 We present a rare case of dysphagia over 2 years duration due to DISH.
Human ; Male ; Hyperostosis, Diffuse Idiopathic Skeletal ; Deglutition Disorders

Compression fractures are the most common vertebral fractures. They involve the anterior column of the spine, and are considered stable fractures due to the presence of intact posterior ligaments that aid in resisting further collapse and deformity. They are thus often managed conservatively. We describe a series of 3 cases that were initially diagnosed as compression fractures and managed conservatively. With the abundance of compression fractures and increase in preference for conservative management of compression fractures, it is of utmost importance to recognize the possibility of other spinal co-pathologies, especially that of hyperostosis of the spine, both by clinical judgment as well as radiological analysis before embarking on conservative management, should there be under-treatment and development of complications that could have otherwise been avoided, as in the cases presented in this series.
Congenital Abnormalities ; Fractures, Compression* ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Judgment ; Ligaments ; Radiography ; Spine

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier's disease and ankylosing hyperostosis, is a relatively common disease that predominantly affects middle-aged and elderly men. It is often asymptomatic; especially dysphagia is a rather frequent and prominent symptom, particularly when the cervical spine is involved with the hyperostotic state. A case of DISH, with dysphagia, was experienced, which was treated by excision of the bony spur, with an anterior approach.
Aged ; Deglutition Disorders* ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Male ; Spine*

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier's disease and ankylosing hyperostosis, is a relatively common disease that predominantly affects middle-aged and elderly men. It is often asymptomatic; especially dysphagia is a rather frequent and prominent symptom, particularly when the cervical spine is involved with the hyperostotic state. A case of DISH, with dysphagia, was experienced, which was treated by excision of the bony spur, with an anterior approach.
Aged ; Deglutition Disorders* ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Male ; Spine*

Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis(DISH), is a rare condition. It frequently occurs in elderly men, and is mostly asymptomatic. Patients with severe involvement of the cervical spine may, however, develop dysphagia, dysphonia, dyspnea, and foreign body sensation. We decribe that one case of Forestier's disease with dysphagia, successfully treated by surgery, and also present a review the literature.
Aged ; Deglutition Disorders* ; Dysphonia ; Dyspnea ; Foreign Bodies ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; Male ; Osteophyte* ; Sensation ; Spine

Anthropological study on human skeletons from Joseon tomb, for confirming Ryu Ja-Gwang, a famous historical figure of medieval Korea. Ryu Ja-Gwang was the famous figure of Joseon Dynasty who achieved great successes in royal court. According to the records in Joseon Dynasty, he tried to hide his own tomb after death under the apprehension that the political enemies might do harm to his corpse. In 1974, the descendants of Younggwang Ryu clan discovered a Joseon tomb that was lost for the past several hundred years. Since they suspected if the tomb might be their legendary ancestor's, anthropological studies were asked to be done on the skeletons collected from the tomb. In our study, the estimated stature of a male from the tomb was 160.5+/-3.8 cm. The age at death was estimated to be 58.6+/-5.2. He seems to have been suffered from diffuse idiopathic skeletal hyperostosis (DISH), the disease prevalent among the people taking high-caloric diets. Since nuclear DNA could not be amplified in this case, the personal identification of the dead person could not be successfully traced by molecular techniques. Taken together, we could not conclude that the skeletons were those of Ryu Ja-Gwang because the radiocarbon dating, age at death or height data could not be well matched with those described in historical documents. Even so, this study could be significant to the related researchers because it was one of the first trials to identify debatable historical figure using various anthropological techniques. Considering that the anthropological studies on famous historical people have been performed briskly, our study could be the basis for the similar studies in Korea, performed in near future.
Cadaver ; Diet ; DNA ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; Korea ; Male ; Radiometric Dating ; Skeleton ; Tooth

Forestier's disease is a systemic rheumatological abnormality in which exuberant ossification occurs along ligaments throughout the body, but most notably the anterior longitudinal ligament of the spine. This disease is usually asymptomatic; however dysphagia, dyspnea, and peripheral nerve entrapment have all been documented in association with the disorder. We report a rare case of catastrophic neurologic damage caused by Forestier's disease accompanying ossification of the posterior longitudinal ligament.
Deglutition Disorders ; Dyspnea ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Ligaments ; Longitudinal Ligaments* ; Peripheral Nerves ; Spine

OBJECTIVETo investigate the clinical effects and operative options for the treatment of Forestier disease.

METHODSFrom June 2005 to May 2012, 8 patients with progressive dysphagia due to Forestier disease were treated through anterior approach, their clinical data were retrospective analyzed. There were 6 males and 2 females, aged from 65 to 83 years old with an average of 73 years. Among the patients, osteophytes removal was performed in 3 cases, osteophytes removal with discectomy and fusion was performed in 2 cases, osteophytes removal with corpectomy and fusion was performed in 3 cases. According to Bazaz dysphagia score to assess the improvement of the patients' symptoms before and after operation.

RESULTSAll patients were followed up from 12 to 40 months with the mean of 18.5 months. Seven cases were asymptomatic and 1 case had mild symptom in the last follow-up. Radiographs showed the space enlargement between vertebral body and trachea.

CONCLUSIONIt is effective to treat patients with progressive dysphagia due to Forestier disease through surgical method. And the operative options depend on the stability of cervical spine and the neurological symptoms of the patients.

Symptomatic diffuse idiopathic skeletal hyperostosis (DISH) is not common. Gelfoam is one of the most commonly used topical hemostatic agents. But, in the partially moistened state, air retained in its pores may result in excessive expansion on contact with liquid. The onset of swallowing difficulty after anterior cervical spine surgery due to appling gelfoam is a rare complication. A 77-year-old man with swallowing difficulty was admitted to our hospital and we diagnosed him as DISH confirmed by radiological study. After removing the DISH, patient's symptom was relieved gradually. However, on postoperative day (POD) 7, the symptom recurred but lesser than the preoperative state. We confirmed no hematoma and esophageal perforation on the operation site. We observed him closely and controlled the diet. Three months later, he had no symptom of swallowing difficulty, and was able to be back on a regular diet, including solid foods. We present a complication case of swallowing difficulty occurring by gelfoam application.
Deglutition ; Diet ; Esophageal Perforation ; Gelatin Sponge, Absorbable ; Hematoma ; Hyperostosis, Diffuse Idiopathic Skeletal ; Spine