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>Journals >Cirugía y Cirujanos >Year 2012, Issue 5

Zárate-Kalfópulos B, Jerez-Saldaña O, Romero-Vargas S, Juárez-Jiménez HG, Rosales-Olivarez LM
Forestier disease. Case report and literature review
Cir Cir 2012; 80 (5)

Language: Español
References: 28
Page: 451-454
PDF: 147.04 Kb.

[Full text - PDF]


Background: Forestier disease is a systemic disorder characterized by ossification of the anterior spinal longitudinal ligament (ALL) in at least three adjacent vertebrae, and diffuse spinal enthesopathy. Indication for surgical treatment is rare and limited to cases of related myelopathy, fracture or significant dysphagia. Few cases of surgical treatment are reported in Medical literature. Surgical treatment depends on the particular symptoms or complications, and usually involves osteophytectomy through the standard anterior approach. Surgery may bring about complications such as pharyngeal paralysis, thrombosis, infections and respiratory obstruction.
Clinical case: 79-year old male with dysphagia of 10 years of evolution, and hoarseness and respiratory distress since 8 years ago. Screening studies showed a diffuse calcification of anterior longitudinal ligament along with large cervical osteophytes. Forestier disease and secondary dysphagia were diagnosed. Surgical treatment consisted of resection of bone exostoses in C4 and C5 vertebral bodies. Six months after surgery, the patient reported improvement of esophageal and respiratory symptoms without evidence of recurrence on imaging studies.
Conclusions: data on Forestier disease’s epidemiological nature and impact on life quality in Mexico is unknown. An increased on its occurrence is projected as Mexican population ages. An observational study is required to identify the characteristics of this disease in Mexico.

Key words: Forestier disease, diffuse idiopathic skeletal hyperostosis, surgical treatment.


  1. Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis 1950;9:321-330.

  2. Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology 1976;119:559-568.

  3. Weinfeld RM, Olson PN, Maki DD, Griffiths HJ. The prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in two large American Midwest metropolitan hospital populations. Skeletal Radiol 1997;26:222-225.

  4. Mader R. Clinical Manifestations of Diffuse Idiopathic Skeletal Hyperostosis of the Cervical Spine. Semin Arthritis Rheum 2002;32:130-135.

  5. Cruz RM, López SM, Padierna LJ, García PD, Franco GM, Nuñez SA. Disfagia: enfermedad de Forestier y Rotes Querol. Rev Gastroenterol Mex 2008;73:181-183.

  6. Bosak V, Zlnay D, Navratil J. Familial and immunogenetic studies in ankylosing hyperostosis (AH, DISH). Scand J Rheumatol 1994;(Suppl. 98):219.

  7. Denko CW, Malemud CJ. Body mass index and blood glucose: correlations with serum insulin, growth hormone, and insulin-like growth factor-1 levels in patients with diffuse idiopathic skeletal hyperostosis (DISH). Rheumatol Int 2006;26:292-297.

  8. Kiss C, Szilágyi M, Paksy A, Poór G. Risk factors for diffuse idiopathic skeletal hyperostosis: a case-control study. Rheumatology 2002;41:27-30.

  9. Sencan D, Elden H, Nacitarhan V, Sencan M, Kaptanoglu E. The prevalence of diffuse idiopathic skeletal hyperostosis in patients with diabetes mellitus. Rheumatol Int 2005;25:518-521.

  10. Havelka S, Uitterlinden G, Fang Y, Arp PP, Pavelková A, Veselá M, et al. Collagen Type I and Vitamin D Receptor Polymorphisms in Diffuse Idiopathic Skeletal Hyperostosis. Clin Rheumatol 2002;21:347-348.

  11. Hanallah D, White AP, Goldberg G, Albert TJ. Diffuse Idiopathic Skeletal Hyperostosis. Oper Tech Orthop 2007;17:174-177.

  12. Jordana X, Galtés I, Couto AR, Gales L, Damas M, Lima M, et al. The coexistence of ankylosingspondylitis and diffuse idiopathic skeletal hyperostosis- a postmortem diagnosis. Clin Rheumatol 2009;28:353-356.

  13. Atzeni F, Sarzi-Puttini P, Bevilacqua M. Calcium Deposition and Associated Chronic Diseases (Atherosclerosis, Diffuse idiopathic Skeletal Hyperostosis and Others). Rheum Dis Clin N Am 2006;32:413-426.

  14. Di Franco M, Mauceri MT, Sili-Scavalli A, Iagnocco A, Ciocci A. Study of Peripheral Bone Mineral Density in Patients with Diffuse Idiopathic Skeletal Hyperostosis. Clin Rheumatol 2000;19:188-192.

  15. Eser P, Bonel H, Seitz M, Villiger PM, Aeberli D. Patients with diffuse idiopathic skeletal hyperostosis do not have increased peripheral bone mineral density and geometry. Rheumatology 2010;49:977-981.

  16. Granville LJ, Musson N, Altman R, Silverman M. Anterior cervical osteophytes as a cause of pharyngeal stage dysphagia. J Am Geriatr Soc 1998;46:1003-1007.

  17. Maseiro S, Padoan E, Bazzi M, Ponzoni A. Dysphagia due to diffuse idiopathic skeletal hyperostosis: an analysis of five cases. Rheumatol Int 2010;30:681-685.

  18. Marks B, Schober E, Swoboda H. Diffuse idiopathic skeletal hyperostosis causing obstructing laryngeal edema. Eur Arch Otorhinolaryngol 1998;255:256-258.

  19. Yoskovitch A, Kantor S. Cervical osteophytes presenting as unilateral vocal fold paralysis and dysphagia. J Laryngol Otol 2001;115:422-424.

  20. Babores M, Finnerty JP. Aspiration pneumonia secondary to giant cervical osteophyte formation (diffuse idiopathic skeletal hyperostosis or Forrestier’s disease: a case report. Chest 1998;114:1481- 1482.

  21. Kritzer RO, Rose JE. Diffuse idiopathic skeletal hyperostosis (DISH) presenting with thoracic outlet syndrome and dysphagia. Neurosurgery 1988;22:1071-1074.

  22. Baxi V, Gaiwal S. Diffuse idiopathic skeletal hyperostosis of cervical spine - An unusual cause of difficult flexible fiber optic intubation. Saudi J Anaesth 2010;4(1): 17-19. Disponible en: http://www.ncbi. nlm.nih.gov/pmc/articles/PMC2900046/

  23. Callahan E, Aguilera H. Complications Following Minor Trauma in Patient with Diffuse Idiopathic Skeletal Hyperostosis. Ann Emerg Med 1993;22:1067-1070.

  24. Storch M, Hubbe U, Glocker FX. Cervical myelopathy caused by soft-tissue mass in diffuse idiopathic skeletal hyperostosis. Eur spine J 2008;17:243-247.

  25. Al-Herz A, Snip J, Clark B, Esdaile M. Exercise therapy for patients with diffuse idiopathic skeletal hyperostosis. Clin Rheumatol 2008;27:207-210.

  26. Carlson M, Archibald D, Graner DE, Kasperbauer JL. Surgical Management of Dysphagia and Airway Obstruction in Patients with Prominent Ventral Cervical Osteophytes. Dysphagia 2010;23. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/20099000

  27. Urrutia J, Bono C. Long-term results of surgical treatment of dysphagia secondary to cervical diffuse idiopathic skeletal hyperostosis. The Spine Journal 2009;9:13-17.

  28. Susuki K, Ishida Y, Ohmori K. Long term follow-up of diffuse idiopathic skeletal hyperostosis in the cervical spine. Neuroradiology 1991;33:427-431.

>Journals >Cirugía y Cirujanos >Year 2012, Issue 5

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