Symptomatic lumbar mobile segment with spinal canal stenosis in a fused spine associated with diffused idiopathic skeletal hyperostosis.
BACKGROUND
Chronic, continuous stress at the junction of a stable/unstable site of the spine in diffuse idiopathic skeletal hyperostosis (DISH) has been reported to cause a nonunion. Back pain resulting from the nonunion has been rarely reported and few operative treatments have been suggested.


OBJECTIVE
To report and discuss the pathogenesis, treatment, and surgical outcome of a rare cause of back pain.


METHODS
Case report of back pain caused by a single lumbar segment is lacking bony union at the caudal end of a fused spine associated with diffuse idiopathic skeletal hyperostosis.


METHODS
Back pain in a 66-year-old man who had suffered for 10 years worsened. The back pain and thigh pain became intolerable, and the left buttock and thigh became numb. Radiographs and computed tomography images showed continuous hyperostosis in the anterior aspect of the vertebral bodies from C2 to L2. At the caudal adjacent level of these fused segments, L2/3 level was mobile and had canal stenosis. Decompression and posterior lumbar interbody fusion (PLIF) were performed.


RESULTS
The pain disappeared soon after the operation. The nonunited segment showed bony union at the 5-year follow-up.


CONCLUSIONS
PLIF may be an option for surgically treating symptomatic nonunited lumbar segments at the caudal end of a fused spine with DISH in cases unresponsive to conservative treatment.
Chi
Daming
D
Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan.
Miyamoto
Kei
K
Hosoe
Hideo
H
Kawai
Gou
G
Ohnishi
Kazuichiro
K
Suzuki
Naoki
N
Sumi
Hiroshi
H
Shimizu
Katsuji
K
D000368:Aged; D001416:Back Pain / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical; D006801:Humans; D015576:Hyperostosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000473:pathology*; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed