Diffuse Idiopathic Skeletal Hyperostosis | Preservation of the Facets

Natural Fusion1

Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a condition involving the enthesis which is loaded with collagen fibers, fibroblasts and other mesenchymal cells, fibrocartilage, and calcified matrix that penetrate the bone cortex at its attachment.

Some classify the condition requiring two or more segments for the diagnosis.

At ddd, we use real specimens to inspire new innovation.  This latest addition to our growing spine collection warranted a teaching moment to those that treat DISH.  If you look closely, the joint space width and pristine nature of the facets indicates that hyperostosis on the anterior aspect of the vertebral bodies naturally act as a perfect balance between motion and immobility.  Just the right amount of spinal stability appears to have yielded the perfect situation for the facets.

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