Lumbar spine in diffuse idiopathic skeletal hyperostosis

Lateral (left) and anteroposterior (right) views of the lumbar spine in a patient with DISH. The changes are more extensive than usual. Radiolucent areas anterior to L3 and L4 (arrows) represent the space between the vertebral body and the ossified anterior longitudinal ligament. There is remarkable preservation of disc height despite the individual's age (93 years).