Exceptional Case Reports of Professional Rugby Players with Diffuse Idiopathic Skeletal Hyperostosis

Abstract: Diffuse idiopathic skeletal hyperostosis (DISH) is an exceptional finding in athletes but may increase spinal injury risk. We report 2 former elite rugby players who, during amateur play, sustained cervical hyperflexion injuries revealing probable DISH. Case 1: transient paraparesis from cervicothoracic ankylosis and cord compression, treated with posterior decompression. Case 2: transient monoparesis with C1–C2 instability and anterior osteophytes, managed by Magerl fixation. Spinal rigidity from DISH heightens fracture and neural injury risk in collision athletes. Magnetic resonance imaging screening may miss ankylosis; computed tomography should be considered in high-risk individuals, especially after professional retirement.