A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis

Albayrak, İlknur; Bağçacı, Sinan; Sallı, Ali; Küçükşen, Sami; Uğurlu, Hatice

doi:10.3904/kjim.2013.28.5.614

Cited by 21 publications

(14 citation statements)

References 11 publications

(11 reference statements)

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“…24,53,[55][56][57] If the extrinsic cause is more prominent, in case of more severe problems and impairment of the quality of life, surgical resection of the osteophytes via a standard anterior approach is performed. 4,[24][25][26][27][28] This can achieve sufficient improvement with a low morbidity rate 4,17 ; regression of the symptoms can occur quickly (in up to 2 weeks) but may sometimes take months. 21,26,27,30,58 The results are more limited the more advanced the changes in the esophagus itself are (inflammation, fibrosis, impaired peristalsis, etc.).…”

Section: Discussionmentioning

confidence: 99%

“…4,22,23 When the extrinsic cause of the compression is the most prominent, surgical resection of the osteophytes via a standard anterior approach can be performed for more severe conditions and impairment of the quality of life. 4,[24][25][26][27][28] The results are less satisfactory the more the changes in the esophagus itself have progressed. 4,29 The resection of the osteophytes does not eliminate the underlying disease, so new ossification can develop.…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment of anterior cervical osteophytes causing dysphagia

Ruetten

Baraliakos

Godolias

et al. 2019

J Orthop Surg (Hong Kong)

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Dysphagia due to anterior cervical osteophytes is a rare condition. However, it can become serious enough to permanently impair the quality of life up to making normal food intake impossible. If conservative treatment fails, there is the option of surgical resection of the osteophytes. The objective of this study was to assess the outcomes of resections of anterior cervical osteophytes causing spondylogenic dysphagia, taking literature into consideration. Method: Resection of anterior cervical osteophytes using a standard anterior approach was performed in 14 consecutive patients with spondylogenic dysphagia between 2009 and 2015. Indomethacin or radiation was used to prevent recurrence. Imaging and clinical data were collected in follow-up examinations over an average of 50 months. Results: The osteophytes were sufficiently resected in all cases. Anterior plates were placed in three patients due to pronounced segmental mobility. Five patients were given recurrence prevention in the form of indomethacin, nine with radiation. One patient required revision surgery for a hematoma. No other serious complications were observed. All patients had significant improvement of their symptoms. No recurrences or signs of increasing instability were found during the follow-up period. Conclusion: When conservative treatment fails, surgical resection of cervical osteophytes is a sufficient method for treating spondylogenic dysphagia. High patient satisfaction and improvement of the quality of life are achieved with a low complication rate. Routine additional stabilization has been discussed as recurrence prevention. Prophylaxis using indomethacin or radiation, known primarily from hip replacement, also appears to be an option.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical treatment of anterior cervical osteophytes causing dysphagia

Ruetten

Baraliakos

Godolias

et al. 2019

J Orthop Surg (Hong Kong)

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“…However, difficulty swallowing is rarely a symptom of AS. Moreover, dysphagia associated with cervical vertebral disease is usually observed in diffuse idiopathic skeletal hyperostosis (DISH) but is rarely related to AS with cervical spine involvement[ 4 , 5 ]. Therefore, it is necessary to distinguish the difference between DISH and AS.…”

Section: Discussionmentioning

confidence: 99%

Dysphagia in a patient with ankylosing spondylitis: A case report

Wang

Zhang

2021

WJCC

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BACKGROUND Ankylosing spondylitis (AS) is a systematic and rheumatic disease, which causes multiple symptoms. However, dysphagia due to the formation of a giant anterior cervical osteophyte is rare in patients with AS. CASE SUMMARY We present the case of a 65-year-old male patient who was diagnosed with AS and visited the hospital with a complaint of progressive dysphagia. The appropriate imaging examinations indicated that a giant anterior cervical osteo-phyte at C3-4 caused esophageal compression, which led to dysphagia. An operation for resection was performed without complications. CONCLUSION This case demonstrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS, and early accurate diagnosis and surgical treat-ment are very important for the improvement of symptoms. Anterior cervical discectomy and fusion are extremely effective and should be taken into consideration.

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“…Usually, initially all cases, especially mild-to-moderate cases are treated with conservative methods, such as dietary modifications by changing their food habits toward softer diet, drinking plenty of water with food, taking more frequent meals with smaller quantity at a time, and taking enough time to complete the meal;[19] also, a prescription of nonsteroidal anti-inflammatory drugs in the early stage usually helps.…”

Section: Discussionmentioning

confidence: 99%

Timing for surgical intervention in DISHphagia

Hamouda

2018

J Craniovert Jun Spine

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Introduction:Dysphagia in old patients secondary to diffuse idiopathic skeletal hyperostosis (DISH) syndrome is underdiagnosed. Surgical resection of the offending osteophytes is the definitive treatment. However, the timing of surgery in the course of the disease is still controversial. The study tries to find a correlation if any, between the timing of osteophytectomy surgery aimed to relieve DISH syndrome-induced dysphagia and the surgical outcome.Methods:During the period from 2010 to 2015, clinical and radiological data of patients who presented with dysphagia attributed to DISH syndrome were retrospectively reviewed along with their management and outcome.Results:One female and seven male patients were included in the study. Mean age was 71 years. Mean duration of dysphagia was 3 years and 10 months. Surgical resection was attempted through anterolateral cervical approach in five cases who were fit for surgery, in which four showed complete resolution of dysphagia (one experienced transient hoarseness of voice for 4 weeks postoperatively), and the fifth showed minimal improvement after limited resection due to intraoperative finding of marked esophageal adherence to osteophytes. The two unfavorable outcomes (subtotal resection and transient hoarseness of voice) occurred in relatively older patients (average: 75.5 years) with longer standing dysphagia (average: 7 years).Conclusion:DISH syndrome as a cause of dysphagia is commonly underlooked. Surgical resection of the offending osteophytes through an anterolateral approach is a safe and effective procedure. For patients who are fit for surgery, older age or longer duration of dysphagia might be associated with less favorable surgical outcome.

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A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis

Cited by 21 publications

References 11 publications

Surgical treatment of anterior cervical osteophytes causing dysphagia

Surgical treatment of anterior cervical osteophytes causing dysphagia

Dysphagia in a patient with ankylosing spondylitis: A case report

Timing for surgical intervention in DISHphagia

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