Patient characteristics, surgical treatment, and outcomes in spinal gout: a systematic review of 315 cases

Abstract

Purpose To systematically investigate all published literature on spinal gout regarding location demographics, patient characteristics, treatment, and outcomes. Methods We performed a systematic literature search of Medline and EMBASE from inception until April 15, 2023. Two investigators performed data extraction and quality assessment of location demographics and patient characteristics and outcomes of all article types describing spinal gout. Results A total of 214 articles (204 case reports and 10 case series) were included, encompassing 315 subjects with spinal gout (81% male, mean age 58.1 years; range: 16–92). Most cases (36%) were between the age of 60–69 years. We observed an increase in publications and cases from 1950 to the present. Most patients were from institutions in Asia (n = 119, 37.8%) and North America (n = 96, 30.5%). Reported symptoms frequently included back pain (75%), radiating pain to extremities (27.3%), and weakness in the extremities (26.3%). The lumbar spine was most often affected. Pharmacological treatment was described for 108 (34.2%) patients. Surgery was performed for 146 (46.3%) of patients, of which 4.8% had postoperative complications. Three patients (2%) required secondary surgery for recurrence. Conclusion Published cases of spinal gout have increased over the last decades. Patient characteristics of spinal gout were similar to findings in systemic gout. Trends identified in patient characteristics and treatment outcomes may help guide patient management and improve our understanding of spinal gout.

Understanding spinal gout: A comprehensive study of 88 cases and their clinical implications

“…Cases of gout in the spine often exhibit a predilection for specific locations. Consistent with previous studies,[ 66 80 ] in this study, the lumbar spine emerged as the most frequently affected site. In an effort to comprehend the underlying mechanisms of spinal gout, ongoing research aims to identify the factors influencing the development of gout in the spine and its relationship with clinical presentation and diagnostic outcomes.…”

“…[ 11 ] This study has yielded 88 cases of spinal gout over the past decade, with the majority occurring in adults within the age range of 60–69 years. Consistent with the findings of a study conducted by Harlianto,[ 80 ] cases of spinal gout in males significantly outnumber those in female patients, with a gender ratio of 1:8.9.…”

“…Recent studies have suggested that DECT has become a promising diagnostic modality for patients with gout. [ 14 80 ] CT is a non-invasive method that can assist clinicians in measuring the levels of urate crystal deposits, aiding in diagnosing gout in patients with complex and atypical clinical presentations. [ 83 ] However, it is important to note that to confirm the diagnosis definitively, joint aspiration is often required, where synovial fluid from the symptomatic joint is collected to examine urate crystals.…”