Dysphagia caused by anterior hyperostosis of cervical spine

Abstract: Several disorders of the nervous system and some oesophageal diseases cause dysphagia; rarely is this symptom due to anterior cervical osteophytosis. We report a case of a 64-year-old man with dysphagia for solid foods associated with hypotrophy and weakness of the right arm. Magnetic resonance imaging at the C6-C7 level showed a marked compression of the spinal cord. CT scan revealed oesophageal compression due to an anterior osteophyte at the C4-C6 level. The barium-swallow test showed oesophageal compression at the pharyngo-oesophageal junction. Several pathogenetic mechanisms are proposed: inflammatory reaction around the oesophagus, interference with oesophageal peristalsis, and interference at the pharyngo-oesophageal junction, as in our case. The severity of dysphagia is usually proportional to the dimensions of the cervical osteophyte. Medical treatment in slight cases, or surgical excision in severe cases, is suggested. Anterior cervical osteophytosis should be considered for a correct differential diagnosis as the cause of dysphagia in "neurological" patients with anomalies of the cervical spine if the symptom is unrelated to any nervous system disorder.