DYSPHAGIA CAUSED BY ANTERIOR CERVICAL OSTEOPHYTES

Abstract

Although cervical spondylosis is a common disorder, dysphagia induced by osteophyte formation is uncommon. Reports in the literature show that vertebral hypertrophic spurs causing dysphagia result from bony degeneration or idiopathic causes (diffuse idiopathic skeletal hyperosteosis: DISH) (Forestier's disease). We present a case suffering dysphagia secondary to cervical osteophytes. A 62-year-old male patient presented with a complaint of dysphagia. Physical examination showed no abnormality. A cervical X-ray and computed tomography (CT) showed a large bone spur originating from the anterior surface of the C3/4. Barium esophagography revealed osteophytic spurs in the anterior aspect of C3/4 vertebrae, in close approximation to the inlet of the esophagus, obstructing the esophagus passage by external compression. Anti-inflammatory therapy administered did not provide relief of the patient's complaint. Functional improvement was immediate after surgical removal of the osteophyte using ultrasonic bone curettage via an anterior cervical approach. Surgery is mandatory if medical care fails and dysphagia is complete.