If there are few or no symptoms or complications, then life expectancy and quality of life will not be impacted by a diagnosis of DISH. However, in patients with pain, dysphagia, airway obstruction, and fracture, DISH may have a drastic impact on the patient's quality of life. In these patients, surgical interventions such as resection of cervical osteophytes and fracture fixation can alleviate symptoms and significantly improve quality of life.[68]Mattioli F, Ghirelli M, Trebbi M, et al. Improvement of swallowing function after surgical treatment of diffuse idiopathic skeletal hyperostosis: our experience. World Neurosurg. 2020 Feb;134:e29-36.
http://www.ncbi.nlm.nih.gov/pubmed/31470164?tool=bestpractice.com
[69]Lofrese G, Scerrati A, Balsano M, et al. Surgical treatment of diffuse idiopathic skeletal hyperostosis (DISH) involving the cervical spine: technical nuances and outcome of a multicenter experience. Global Spine J. 2022 Oct;12(8):1751-60.
https://journals.sagepub.com/doi/10.1177/2192568220988272
http://www.ncbi.nlm.nih.gov/pubmed/33590802?tool=bestpractice.com
Spinal fracture in patients with DISH is associated with increased risk of mortality; compared with non-surgical treatment of fractures, surgery is linked to lower mortality rates.[1]Le HV, Wick JB, Van BW, et al. Diffuse idiopathic skeletal hyperostosis of the spine: pathophysiology, diagnosis, and management. J Am Acad Orthop Surg. 2021 Dec 15;29(24):1044-51.
http://www.ncbi.nlm.nih.gov/pubmed/34559699?tool=bestpractice.com
Correlations between DISH and numerous other conditions have been noted, including metabolic syndrome, coronary artery disease, and aortic disease.[2]Kuperus JS, Mohamed Hoesein FAA, de Jong PA, et al. Diffuse idiopathic skeletal hyperostosis: etiology and clinical relevance. Best Pract Res Clin Rheumatol. 2020 Jun;34(3):101527.
https://www.sciencedirect.com/science/article/pii/S1521694220300449
http://www.ncbi.nlm.nih.gov/pubmed/32456997?tool=bestpractice.com
[16]Fassio A, Adami G, Idolazzi L, et al. Diffuse idiopathic skeletal hyperostosis (DISH) in type 2 diabetes: a new imaging possibility and a new biomarker. Calcif Tissue Int. 2021 Feb;108(2):231-9.
http://www.ncbi.nlm.nih.gov/pubmed/33047242?tool=bestpractice.com
[17]Okada E, Ishihara S, Azuma K, et al. Metabolic syndrome is a predisposing factor for diffuse idiopathic skeletal hyperostosis. Neurospine. 2021 Mar;18(1):109-16.
https://e-neurospine.org/journal/view.php?doi=10.14245/ns.2040350.175
http://www.ncbi.nlm.nih.gov/pubmed/33211945?tool=bestpractice.com