Myelopathy by lesions of the craniocervical junction in a patient with forestier disease.
METHODS
The authors report a case of a patient with diffuse idiopathic skeletal hyperostosis (DISH) associated with basilar impression resulting in tetraparesis.


OBJECTIVE
To describe neurologic compromise associated with DISH.


BACKGROUND
Neurologic deficits due to DISH are very rare, and only 1 case of basilar impression associated with DISH has previously been reported in the literature.


METHODS
Diagnosis was confirmed by radiograph and MRI, which demonstrated basilar impression associated with a hyperintense signal in the spinal cord on T2-weighted sequences. Transoral resection of the dens associated with posterior occipitocervical fixation was performed during the same anesthesia.


RESULTS
Postoperative outcome demonstrated regression of the pyramidal signs without recovery of unassisted walking.


CONCLUSIONS
Early MRI should be performed in the evidence of spinal cord suffering in patients with DISH. Transoral approach allowed a good decompression of the spinal cord.
Pascal-Moussellard
Hugues
H
Service Orthopédie Pr. Saillant, CHU Pitié-Salpétrière, Paris, France. hpmous@sasi.fr
Drossard
Guillaume
G
Cursolles
Jean-Christophe
JC
Catonné
Yves
Y
Smadja
Didier
D
D000369:Aged, 80 and over; D001269:Atlanto-Occipital Joint / Q000601:surgery; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D004057:Hyperostosis, Diffuse Idiopathic Skeletal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D016268:Internal Fixators; D008279:Magnetic Resonance Imaging; D008297:Male; D009809:Odontoid Process / Q000601:surgery; D010985:Platybasia / Q000150:complications* / Q000175:diagnosis; D011782:Quadriplegia / Q000209:etiology*; D014057:Tomography, X-Ray Computed