Clinical Report of 14 Cases for Diffuse Idiopathic Skeletal Hyperostosis Combined with Thoracolumbar Fractures
Objective:To analyze the characteristics of cases with diffuse idiopathic skeletal hyperostosis(DISH)combined with thoracolumbar vertebral fractures.Methods:A retrospective analysis was conducted on 14 cases of DISH combined with thoracolumbar vertebral fractures treated from January 2018 to October 2022.The spinal injury types were evaluated based on X-rays,CT,and MRI with anterior column through intervertebral disc injury fractures in 5 cases,through bone injury fractures in 3 cases,mixed fractures in 3 cases,and unstable fractures in 3 cases.All patients underwent posterior approach thoracolumbar vertebral fracture open reduction and internal fixation with pedicle screw surgery.Comparison of surgical time,intraoperative blood loss,preoperative,postoperative 3 months,and last follow-up visual analogue scale(VAS)for pain,Oswestry disability index(ODI),Japanese orthopedic association(JOA)scores,and American spinal in-jury association(ASIA)spinal cord injury grading were used to evaluate the efficacy.Results:There were no significant differences in surgical time,intraoperative blood loss among patients(P＞0.05).Compared with preoperative values,at postoperative 3 months and last follow-up,lumbar pain VAS scores,leg pain VAS scores,and ODI significantly decreased,showing statistical significance(P＜0.05).JOA scores significantly increased at postoperative 3 months and last follow-up,demonstrating statistical significance(P＜0.05).ASIA grades of patients were 1 case of grade C and 13 cases of grade D preoperatively.At the last follow-up,3 cases were grade D and 11 cases were grade E,indicating significant im-provement in neurological function compared to preoperative status.Conclusion:Due to the characteristic features of DISH,patients are more prone to vertebral fractures.Clinicians should differentiate it from other diseases and provide rational diagnosis and treatment to avoid misdiagnosis and missed diagnosis.
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