On the Symptomatology and Neurosurgical Treatment of Senile Ankylosing Hyperostosis of the Spine (Forestier)

Abstract

Spondylosis hyperostotica as an isolated ossification of the anterior longitudinal ligament of the vertebral column was first mentioned in 1824 by Wenzel and was described by Forestier and Rotes-Querol as an independent disease in 1950 [1]. Spondylosis hyperostotica occurs mainly in male patients during middle age. Ossification of the anterior longitudinal ligament in the cervical region is very rare, and for this reason we wish to describe some observations of our own:

• 1. A 56-year-old man had been suffering from dysphagia and dyspnea for 1 year. Twenty-six years previously he had had an accident involving the cervical vertebral column. Clinically we found somewhat reduced mobility in the cervical region. Neurologically we found a normal status. The indication for the operation was the severe dysphagia. The X-ray films of the cervical vertebral column showed an extended position with extreme ventral ossification from C2 to C4 and a diameter of the lumen of the trachea of 5 mm. Cervical myelography yielded no pathological findings. During suigery to remove the exostosis, we found marked degeneration of the disk C3/4. This disk was removed, and fusion after Cloward was performed in this region (Figs. 1–3).

• 2. A 59-year-old man had been suffering from a worsening cervicomedullary syndrome for 2 years. The X-ray films of the cervical vertebral column demon-strated marked ossification of the anterior ligament from C3 to the upper thoracic region. In the region of C5/6 there was a dorsal osteophyte with narrowing of the spinal canal. We performed a laminectomy from C5 to C7 and attained a remarkable improvement.