Diffuse idiopathic skeletal hyperostosis in the cervical spine

The disease processes diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, and ossification of the posterior longitudinal ligament are si milar in pathology and can lead to unexpected but grossly unstable fracture s that may not be diagnosed until neurologic change occurs in cases of triv ial trauma. A retrospective study of 29 patients with cervical spinal fract ures and diffuse idiopathic skeletal hyperostosislike pathologies was done. Twenty patients with an average age of 62 years were treated surgically (s ix neurologically complete, five incomplete, nine intact). Three patients w ith an average age of 70 years died postoperatively (one complete, two inco mplete). Nine patients with an average age of 65 years were treated conserv atively (five neurologically complete, two incomplete, two intact), All pat ients with intact neurologic function survived. It is suggested, therefore, that all elderly patients with diffuse idiopathic skeletal hyperostosislik e pathology, history of trivial trauma, and complaint of neck pain be exami ned carefully for fractures, because mortality rates increase sharply in pa tients with decreased neurologic function.