en Spine Case report <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:200%"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Background and Importance</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">: Diffuse idiopathic skeletal hyperostosis (DISH) can compress the trachea and esophagus when located in the cervical spine. In this report, we investigated whether it is preferable to perform the early surgical intervention in symptomatic patients or to wait and administer supportive care and perform late surgical intervention regardless of whether symptoms progress or not. </span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:200%"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Case Presentation:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times=""> We present the case of a 70-year-old patient with diffuse idiopathic skeletal hyperostosis (DISH) causing significant dysphagia and unilateral vocal cord paresis, resulting in dyspnea and stridor. Imaging diagnostics revealed large osteophytes anterior to the cervical spine from C3 to C6 compressing the cervical spine. Significant clinical improvement was observed following the anterior resection of the patient&#39;s osteophytes. </span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:200%"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times=""> In order to achieve higher success and less recurrence, it is preferable to perform surgical intervention earlier in the disease&#39;s progression. However, more studies are necessary to confirm this because most of the present results are from case report articles and have less evidence. </span></span></span></span></span></span></span><br> &nbsp;</div> Dysphagia, Cervical spine, Osteophytes, Diffuse idiopathic skeletal hyperostosis (DISH) 107 112 http://irjns.org/browse.php?a_code=A-10-530-1&slc_lang=en&sid=1 Misagh Shafizad Mi.shafizad@gmail.com 100319475328460011286 100319475328460011286 No Department of Neurosurgery, School of Medicine, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran Pooria Sobhanian Drpooriasobhanian@outlook.com 100319475328460011287 100319475328460011287 Yes Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Erfan Ghadirzadeh er.ghadirzadeh@gmail.com 100319475328460011288 100319475328460011288 No Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Rostam Poormousa rostam.pourmousa@gmail.com 100319475328460011289 100319475328460011289 No Department of Otolaryngology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Gholam-ali Godazandeh godazandeh.gh@gmail.com 100319475328460011290 100319475328460011290 No Department of Surgery, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran