Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a Risk Factor for Further Surgery in Short-segment Lumbar Interbody Fusion

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2014 Oct 2

PMID 25271072

Citations 24

Authors

Bungo Otsuki

Shunsuke Fujibayashi

Mitsuru Takemoto

Hiroaki Kimura

Takayoshi Shimizu

Shuichi Matsuda

Affiliations

Soon will be listed here.

Abstract

Purpose: To elucidate the effect of diffuse idiopathic skeletal hyperostosis (DISH) on the clinical results of short-segment lumbar interbody fusion (LIF) for the treatment of degenerative lumbar spinal diseases.

Methods: The 208 patients who underwent one- or two-level LIF were selected as the subjects of this study. Patients with prior lumbar fusion surgery or follow-up <1 year were excluded. Outcome measures were surgery-free survival or the need for further surgery for pseudoarthrosis and/or adjacent segment disease (ASD). The Cox proportional-hazards model was used to identify possible risk factors (DISH, age, sex, number of levels fused, level of the lowest instrumented vertebra, and laminectomy adjacent to the index fused levels) for further surgery.

Results: Among the 208 patients (39 with DISH), 21 patients required further surgery during follow-up. Cox analysis showed that DISH (hazard ratio = 5.46) and two-level fusion (hazard ratio = 2.83) were significant independent predictors of further surgery. Age, sex, level of the lowest instrumented vertebra, and laminectomy adjacent to the index fused levels were not significant predictors.

Conclusions: DISH after short-segment LIF surgery is a significant risk factor for further surgery because of pseudoarthrosis or ASD.

Citing Articles

Intervertebral Disc Degeneration Mediates the Causal Effect of Genetically Predicted Diffuse Idiopathic Skeletal Hyperostosis on Spinal Stenosis: Evidence From a Mendelian Randomization Study.

Shen Y, Jiang Y, Jiang R, Huang Y, Zhan S, Wang Y JOR Spine. 2025; 8(1):e70041.

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Posterior Instrumentation without Curettage Promotes Rapid Restoration of Adult Spinal Langerhans Cell Histiocytosis.

Otsuki B, Kimura H, Fujibayashi S, Shimizu T, Sono T, Murata K Spine Surg Relat Res. 2024; 8(6):637-643.

PMID: 39659370 PMC: 11625713. DOI: 10.22603/ssrr.2024-0040.

Imaging Features of Early Diffuse Idiopathic Skeletal Hyperostosis (pre-DISH): Analysis of Progression of Ligament Ossification over 5 Years by Computed Tomography.

Murakami Y, Morino T, Hino M, Misaki H, Kinoshita T, Takao M Spine Surg Relat Res. 2023; 7(5):443-449.

PMID: 37841032 PMC: 10569810. DOI: 10.22603/ssrr.2022-0226.

Negative Effects of Diffuse Idiopathic Skeletal Hyperostosis on Bone Fusion after Transforaminal Lumbar Interbody Fusion.

Hagihara S, Ohta H, Tanaka J, Shiokawa T, Kida Y, Iguchi Y Asian Spine J. 2023; 17(5):818-825.

PMID: 37788972 PMC: 10622827. DOI: 10.31616/asj.2022.0453.

Minimally invasive LLIF surgery to decrease the occurrence of adjacent-segment disease compared to conventional open TLIF.

Otsuki B, Fujibayashi S, Shimizu T, Murata K, Masuda S, Matsuda S Eur Spine J. 2023; 32(9):3200-3209.

PMID: 37314580 DOI: 10.1007/s00586-023-07806-1.

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