title: Myelopathy by lesions of the craniocervical junction in a patient with forestier disease.
abstract: 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.
authors.affiliation: Service Orthopédie Pr. Saillant, CHU Pitié-Salpétrière, Paris, France. hpmous@sasi.fr
authors.forename: Hugues
authors.initials: H
authors.lastname: Pascal-Moussellard
authors.forename: Guillaume
authors.initials: G
authors.lastname: Drossard
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Cursolles
authors.forename: Yves
authors.initials: Y
authors.lastname: Catonné
authors.forename: Didier
authors.initials: D
authors.lastname: Smadja
mesh_terms: 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