Forestier disease. Case report and literature review

• Published in: Cirugia y cirujanos Vol. 80; no. 5; p. 451
• Main Authors: Zárate-Kalfópulos, Barón, Jerez-Saldaña, Omar, Romero-Vargas, Samuel, Juárez Jiménez, Héctor Gerardo, Rosales-Olivarez, Luis Miguel
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01.09.2012
• Subjects: Aged; Cervical Vertebrae - surgery; Deglutition Disorders - etiology; Diagnosis, Differential; Hoarseness - etiology; Humans; Hyperostosis, Diffuse Idiopathic Skeletal - complications; Hyperostosis, Diffuse Idiopathic Skeletal - diagnosis; Hyperostosis, Diffuse Idiopathic Skeletal - epidemiology; Hyperostosis, Diffuse Idiopathic Skeletal - surgery; Male; Mexico - epidemiology; Population Dynamics; Respiration Disorders - etiology; Spondylitis, Ankylosing - diagnosis; Mexico
• ISSN: 2444-054X

Forestier disease is a systemic disorder characterized by ossification of the anterior spinal longitudinal ligament (ALL) in at least three adjacent vertebrae, and diffuse spinal enthesopathy. Indication for surgical treatment is rare and limited to cases of related myelopathy, fracture or significant dysphagia. Few cases of surgical treatment are reported in the medical literature. Surgical treatment depends on the particular symptoms or complications, and usually involves osteophytectomy through the standard anterior approach. Surgery may bring about complications, such as pharyngeal paralysis, thrombosis, infections and respiratory obstruction. 79-year old male with dysphagia of 10 years of evolution, and hoarseness and respiratory distress since 8 years ago. Screening studies showed a diffuse calcification of anterior longitudinal ligament along with large cervical osteophytes. Forestier disease and secondary dysphagia were diagnosed. Surgical treatment consisted of resection of bone exostoses in C4 and C5 vertebral bodies. Six months after surgery, the patient reported improvement of esophageal and respiratory symptoms without evidence of recurrence on imaging studies. Data on Forestier disease's epidemiological nature and impact on life quality in Mexico is unknown. An increase in its occurrence is projected as the Mexican population ages. An observational study is required to identify the characteristics of this disease in Mexico.