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Vol. 19. Issue 4.
Pages 350-355 (January 2008)
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Vol. 19. Issue 4.
Pages 350-355 (January 2008)
Enfermedad de Forestier-Rotes-Querol. Osificación del ligamento longitudinal cervical anterior como causa de disfagia
Forestier-Rotes-Querol's disease. Ossification of the anterior cervical longitudinal ligament as a cause of dysphagia
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L. Alcázar
, P. Jerez, J.C. Gómez-Angulo, M. Tamarit, R. Navarro, J.M. Ortega, P. Aragonés, F. Salazar, J.M. del Pozo
Servicio de Neurocirugía. Hospital Universitario de Getafe. Getafe. Madrid
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Resumen

La enfermedad de Forestier-Rotes-Querol o “hiperostosis esquelética idiopática difusa” es una enfermedad reumatológica con afectación sistémica18. Consiste en la calcificación-osificación del ligamento longitudinal común anterior (LLCA), de etiología aún desconocida, sin otros cambios degenerativos. La región más frecuentemente afectada en el raquis es la región dorsal baja18,28. La mayoría de casos se mantienen asintomáticos o con mínimos síntomas como dolor articular leve y dolor de espalda25. El síntoma más común cuando está implicada la columna cervical es la disfagia; menos frecuente es la disnea, ambos síntomas secundarios a la compresión extrínseca del esófago y la tráquea. La presencia de déficits neurológicos es rara18,21,25. En la década de los 70 se definieron criterios radiológicos específicos para el diagnóstico de la enfermedad de Forestier que todavía hoy se emplean18,28,29,30. Predomina en varones en la década de los 60 años18,25. Presentamos en este trabajo dos casos diagnosticados por alteraciones importantes en la deglución, una mujer de 84 años y un varón de 54 años de edad; ambos fueron intervenidos quirúrgicamente para la extirpación-fresado de una exostosis ósea de gran tamaño existente en C3-C4 y C5-C6, respectivamente, mediante un abordaje anterior convencional a la columna cervical; la mejoría clínica fue inmediata tras la cirugía, con resolución completa del trastorno deglutorio.

Palabras clave:
Enfermedad de Forestier
Disfagia
Hiperostosis esquelética idiopática difusa
Osificación del ligamento longitudinal común anterior
Osteofito cervical
Abreviaturas:
LLCA
ORL
RM
TC
Summary

Forestier's disease or diffuse idiophatic skeletal hyperostosis is a systemic reumathological abnormality of unknown etiology18. It produces calcificationossification of the anterior longitudinal ligament. The low dorsal region is the most affected in the raquis18,28. These patients are tipically asymptomatic or with few symptoms (minimal joint pain, spinal pain, stiffness)25. Dysphagia is the most common symptom when the disease affects the cervical spine; less frequent is dyspnea, both secondary to extrinsic compression of the esophagus and trachea. Neurological complaints are quite rare18,21,25. In the 1970s Resnick described specific radiological criteria for the diagnosis of Forestier's disease that are still used today18,28,29,30. It affects men more frequently than women (2:1); the peak occurrence is in patients in their 60s18,25. We present two cases diagnosed by severe difficulty with deglution, a 84 years-old woman and a 54 years-old man; we operated on them for surgical decompression of the esophagus with resection of osteophytes C3-C4 and C5-C6 respectively through a conventional anterolateral neck approach. Relief of difficulty in swallowing was immediately ensued.

Key words:
Forestier's disease
Dysphagia
Diffuse idiophatic skeletal hyperostosis
Ossification of the anterior longitudinal ligament
Cervical osteophyte

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