Percutaneous endoscopic treatment for cervical ligamentum flavum gouty tophus

Li, Jingchi; Zhang, Xiang; Xi, Zhaodong; Li, Jingchi

doi:10.1097/md.0000000000015665

Cited by 6 publications

(2 citation statements)

References 18 publications

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“…Once the intraspinal tophi picture is established, it is essential to assess the patient comprehensively and provide adequate treatment. If the patient has a spinal cord or root compression that produces progressive neurological deterioration, surgical decompression of the spinal canal could be necessary [ 3 , 16 , 20 ]. The surgical removal of gout tophi usually yields good results.…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Compression Due to Tophaceous Vertebral Gout: A Case Report

Casas¹,

López-Piloto²,

Paz³

et al. 2022

Cureus

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Gout tophi are deposits of urate crystals in subcutaneous tissues and joints which commonly affect the small joints of the feet and hands, causing painful arthritis. The axial skeleton is considered to be seldom affected by gout arthritis. Here we describe the clinical, MRI, and pathologic findings of a 61-year-old male patient with a previous diagnosis of gout who presented with progressive paraparesis and radicular pain. MRI showed extradural masses compressing the spinal cord and roots at two spinal levels. Two surgical interventions were performed to remove these extradural masses, which were pathologically identified as gout tophi. Pain and paraparesis had clinical improvement after surgery. This report highlights that gout can be a cause of paraparesis.

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Section: Discussionmentioning

confidence: 99%

Spinal Cord Compression Due to Tophaceous Vertebral Gout: A Case Report

Casas¹,

López-Piloto²,

Paz³

et al. 2022

Cureus

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show abstract

“…DECT has an advantage in the qualitative detection and overall evaluation of the gout source, and can detect gout deposited in atypical sites such as the spine [ 13 , 14 ]. A meta-analysis [ 15 ] showed that the sensitivity and specificity of DECT were 87% and 84%, respectively, compared with the pathological diagnosis of sodium urate crystal deposition as gold standard. The DECT of our case also supports the diagnosis of spinal gout tophi preoperatively.…”

Section: Discussionmentioning

confidence: 99%

Multilevel Lumbar Stenosis Caused by Large Tophi Involving Both Spinal Canal and Posterior Spinal Elements: A Rare Case Report and Literature Review

Liu

Jiao

et al. 2019

J Med Cases

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Tophus is a characteristic manifestation of gout entering the chronic phase, which usually deposits in the joints of the extremities, skin mucosa, etc. A gout tophus that involves the spine causing spinal stenosis is rare and it can be misdiagnosed as a spinal tumor preoperatively. We report the case of a 35-year-old man who presented with lumbar stenosis symptoms, and suffered multiple-site gout tophi involvement throughout his body. Radiographic examinations showed that the large tophi infiltrated the posterior elements of the spine and encroached the lumbar spinal canal, resulting in neurologic compression from the second to the fifth lumbar level. Urate could be observed on a dual-energy computed tomography. A posterior-based procedure was performed to eradicate the tophi and stabilize the spine. Finally, urate crystal was confirmed by postoperative pathological examination. Here, the clinical manifestations, radiological, pathological and surgical features for this case are reported.

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

Harlianto,

Harlianto

2023

Eur Spine J

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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.

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Percutaneous endoscopic treatment for cervical ligamentum flavum gouty tophus

Cited by 6 publications

References 18 publications

Spinal Cord Compression Due to Tophaceous Vertebral Gout: A Case Report

Spinal Cord Compression Due to Tophaceous Vertebral Gout: A Case Report

Multilevel Lumbar Stenosis Caused by Large Tophi Involving Both Spinal Canal and Posterior Spinal Elements: A Rare Case Report and Literature Review

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

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