弥漫性特发性骨肥厚(DISH)

当退变性脊柱疾病合并重度骨质疏松、强直性脊柱炎或者弥漫性特发性骨肥厚，手术术后并发症会明显增多，也变得很棘手，对脊柱外科医生是一种挑战。

1，Modified Mata 评分

1.    Murakami Y, Morino T, Hino M, Misaki H, Miura H. Progression of Ossification of the Anterior Longitudinal Ligament Associated With Diffuse Idiopathic Skeletal Hyperostosis by Age: A Study of Computed Tomography Findings Over 5 Years. Global Spine J 2021, 11(5): 656-661.

2，平坦型炎症重、钳夹型退变重，主要观察胸椎和胸腰段部位。

1.    Nguyen TCT, Yahara Y, Yasuda T, Seki S, Suzuki K, Watanabe K, Makino H, Kamei K, Mori K, Kawaguchi Y. Morphological characteristics of DISH in patients with OPLL and its association with high-sensitivity CRP: inflammatory DISH. Rheumatology (Oxford) 2022, 61(10): 3981-3988.

3，合并DISH的椎间隙融合时间长、融合率低、容易cage后退。

1.    Kato S, Terada N, Niwa O, Yamada M. Risk Factors Affecting Cage Retropulsion into the Spinal Canal Following Posterior Lumbar Interbody Fusion: Association with Diffuse Idiopathic Skeletal Hyperostosis. Asian Spine Journal 2021, 15(6): 840-848.

4，DISH病常存在节段不稳，所以邻椎病或PJK发生率很高。

1.    Funayama T, Fujii K, Abe T, Kumagai H, Nagashima K, Miura K, Noguchi H, Mataki K, Shibao Y, Koda M, Yamazaki M. Spontaneous symptomatic lumbar intervertebral pseudoarthrosis associated with diffuse idiopathic skeletal hyperostosis treated with a combined posteroanterior fusion: a case report and review of literature. J Spine Surg 2020, 6(3): 626-630.