David Brauge, Pierre Bernard
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.