Spinal Paget's disease with bilevel cord compression and ischemic non‐compressive myelopathy treated with zoledronic acid

Abstract

Cord compression and ischemic non‐compressive myelopathy are a complication of spinal Paget's disease (SPD). SPD usually touches a single spine level. We report an unusual case with bilevel spinal cord compression and dysfunction which was medically treated due to resolution of the vascular steal syndrome.

Surgical decompression in spinal Paget’s disease: illustrative case

“…Multiple examples of the effectiveness of medical therapy are documented. 7 Feki et al 13 reported a 62-year-old patient with both thoracic and lumbar spinal cord compression secondary to PDB, treated with an intravenous infusion of 5 mg of zoledronic acid without surgical intervention. The patient saw a decrease in ALP as well as objective improvements in power and sensory deficits.…”

Newly Diagnosed Monostotic Paget’s Disease of Bone during Living Kidney Donor Candidate Evaluation

“…Nowadays, diagnosis of PDB is usually a secondary finding on an abnormal X-ray, CT, MRI, or hybrid imaging (positron emission tomography and CT; PET/CT) [5,[25][26][27][28][29][30][31] and/or elevated alkaline phosphatase activity of an unknown etiology, as in our patient [21,24]. The characteristics listed above that lead to the diagnosis are related to earlier and wider access to medical examinations.…”

“…The most common PDB involvement sites are the pelvis, lumbar spine, and femur, reported in more than 75% of cases, with the polyostotic disease being more common than the monostotic [13], but the axial skeleton is usually involved. It is assumed that about 75% of patients are asymptomatic [22], although some studies indicate that pain in the affected site is the most common symptom [25][26][27], along with deformity and fracture [22,25]. PDB occurs more often in men than women and is uncommon in people under 50.…”