A CASE OF OSSIFICATION OF THE ANTERIOR LONGITUDINAL LIGAMENT OF THE CERVICAL SPINE WITH DYSPHAGIA DETECTED BY ENDOSCOPY

Abstract

A male in his late 50's visited our hospital with dysphagia which had started 3 months previously. The physical examination showed no abnormal findings except for limited extension of the neck. Upper gastrointestinal endoscopy revealed an extramural compression at the posterior wall of the laryngopharynx. X-ray examination of the cervical spine showed osteophytes at the anterior of the vertebral bodies, and the patient was diagnosed as having ossification of the anterior longitudinal ligament (OALL). MRI and barium meal examination revealed compression of the laryngopharyngeal wall by the osteophytes. The osteophytes (ossified ligament) from C4 to C6 were resected surgically whereafter the symptoms disappeared immediately. Endoscopic and radiographic findings confirmed a marked improvement. The present case clearly showed that OALL can be a cause of dysphagia. Thus, we should not overlook findings of extramural compression at the posterior wall of the laryngopharynx during endoscopic examination of patients who complain of dysphagia.