HYPEREXTENSION INJURIES OF THE THORACIC SPINE IN DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS - REPORT OF 4 CASES

Four patients who had multisegmental ankylosis of the thoracic and lum bar spine due to diffuse idiopathic skeletal hyperostosis sustained a hyperextension fracture-dislocation. The patients had a mean age of si xty-four years (range, fifty-eight to sixty-nine years); all four pati ents were men. All injuries occurred between the seventh and eleventh thoracic vertebrae. All patients had intact neurological function at t he time of admission to the hospital. Three patients were managed with posterior spinal arthrodesis with Cotrel-Dubousset segmental instrume ntation; one patient was managed non-operatively with a molded thoraco lumbosacral orthosis. At a minimum duration of follow-up of twenty-two months (mean, twenty-seven months), the three patients who had been m anaged operatively had healing of the fracture with anatomical alignme nt of the spine and without postoperative complications. The one patie nt who had been managed non-operatively with a brace had severe neurol ogical deterioration and non-anatomical alignment of the spine.