Diffuse Idiopathic Skeletal Hyperostosis

What is it?

Diffuse Idiopathic Skeletal Hyperostosis (DISH), also known as ankylosing hyperostosis, is a noninflammatory disorder characterized by the calcification and hardening of tendons and ligaments where they are attached to the spine. While the causes of the disease are unclear, several factors have been linked to the development of this condition. These risk factors include:

  • Age over 50.
  • Metabolic conditions, such as diabetes mellitus, acromegaly, and obesity.
  • Genetic factors, such as genetic predisposition.

Symptoms

Many people don’t have symptoms. When symptoms occur, they may include:

  • Stiffness and limited range of motion in the back.
  • Pain, especially in the cervical or thoracic spine.
  • Tingling or numbness in the legs from compressed nerves in your lower back.
  • Paralysis from a compressed spinal cord.

Diagnosis

Usually, a diagnosis can be made based on the signs and symptoms present. Various tests may also be performed to rule out other conditions. These tests include: X-ray, Computed tomography scan (CT scan), Magnetic resonance imaging scan (MRI).

Treatment

DISH can’t be cured, but some nonsurgical treatments are effective and can help to greatly reduce symptoms:

  • Exercise and physical therapy.
  • Weight and blood sugar control.
  • Pain relievers.
  • corticosteroid injections.

Surgery may be recommended if diffuse idiopathic skeletal hyperostosis has caused compression of the spinal cord and/or nerve roots. These problems may be fixed by any of the following procedures:

  • Laminectomy, a procedure that removes part of the lamina to create more space.
  • Laminoplasty, a procedure that creates more space for the spinal cord and nerve roots to relieve abnormal pressure on the spinal cord.
  • Corpectomy, where all or part of the vertebral body is removed, usually as a way to decompress the spinal cord and nerves.
  • Discectomy, where abnormal disk material that presses on a nerve root or the spinal cord is removed.
  • Spinal fusion, a procedure where two or more vertebrae are fused together to make the spine more stable.