Abstract
Dysphagia is the commonest complaint with an ossified cervical anterior longitudinal ligament (ALL) and a number of case reports regarding this complaint describe the benefits of surgical resection of the ossified lesion. However, dyspnea has rarely been reported. We report a rare case of dysphagia and dyspnea caused by ossification of the cervical anterior longitudinal ligament. An 81-year-old man was referred for severe dysphagia and dyspnea. He had a few years' history of gradually increasing dysphagia. A few weeks before hospital admission, the patient had noted severe dyspnea while eating. At the time of hospital admission, the patient had manifest respiratory distress with stridor. Radiographs of his cervical spine disclosed marked cervical ossification of the anterior longitudinal ligament. Computed tomography of cervical spine disclosed an ossification lesion at the C3-C7 level that was most pronounced and 14mm in thickness at the C4-C5 level, with anterior occlusion of the esophagus and airway. A barium swallow test revealed a pool at the laryngopharynx and flowing into the trachea of contrast medium. A protrusion of the dorsal pharyngeal wall was found under laryngoscopy. Magnetic resonance imazing disclosed spinal stenosis at the C2/3, C4/5, and C5/6 levels, but there was no neurological anormality. Resection of the ossified lesion was undertaken from C3 to C7 through an anterior approach. After operation, dysphagia and dypnea were improved and a barium swallow test revealed that contrast medium flowed smoothly into the esophagus. Patients with dyspnea benefit from surgical resection of such an ossified lesion.
