Full text

Turn on search term navigation

Copyright © 2025, Shiomi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Diffuse idiopathic skeletal hyperostosis (DISH) increases with aging, as does osteoporotic fracture. DISH spine fractures are sometimes difficult to detect at the initial evaluation and result in neurological compromise. We report a case of unstable DISH spine fracture with neurological deficits developing from an asymptomatic DISH spine fracture. A 98-year-old independent female suffered from a right femoral shaft fracture due to a ground-level fall. After she started early mobilization following fracture surgery, she developed mild back pain and became paraplegic. Imaging studies showed DISH spine fracture at Th10 level with cord compression. She underwent posterior spinal fusion for the DISH spine fracture, but the muscle weakness in her lower limbs persisted. Unlike the painful and non-ambulatory femoral shaft fracture, DISH spine fractures present diagnostic challenges. Asymptomatic cases could result in delayed diagnosis with neurological deficits and other morbidities. Although CT with multiplanar reformatted imaging and MRI are useful for detecting subtle fractures, the requirements for spinal CT and MRI examination in low-energy trauma settings in patients without back pain remain controversial. The proactive diagnostic approach, consisting of physical evaluations for pain and neurological deficits and the complementary imaging studies, should be encouraged for the early detection of hidden spine injury in patients having DISH spine.

Details

Title
Delayed Paraplegia by Thoracolumbar Fracture in Diffuse Idiopathic Skeletal Hyperostosis Developed After Femur Fracture Surgery: A Case Report
Author
Shiomi Masaaki 1 ; Tadokoro Nobuaki 1 ; Satake Yoshinori 1 ; Kiyasu Katsuhito 1 ; Ikeuchi Masahiko 1 

 Orthopedic Surgery, Kochi University, Kochi, JPN 
University/institution
U.S. National Institutes of Health/National Library of Medicine
Publication year
2025
Publication date
2025
Publisher
Springer Nature B.V.
e-ISSN
21688184
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3234800318
Copyright
Copyright © 2025, Shiomi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.