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Lumbar spinal stenosis attributable to tophaceous gout: case report and review of the literature

Authors Wang W, Li QB, Cai L, Liu WJ

Received 9 July 2017

Accepted for publication 24 August 2017

Published 28 September 2017 Volume 2017:13 Pages 1287—1293


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang

Wei Wang, Qingbo Li, Lei Cai, Weijun Liu

Department of Orthopaedics, Pu Ai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China

Objectives: Tophaceous gout seldom affects the axial skeleton. Symptoms vary according to the differential localization of urate deposits and the diagnosis is often delayed. Here, we report an unusual case of lumbar spinal stenosis caused by extradural tophaceous deposits.
Methods: We retrospectively reviewed a case of a patient with tophaceous gout of the lumbar spine and reviewed the relevant literature.
Results: A 62-year-old man with a 2-year history of lower back pain and a 3-month history of lower limb radiation pain and intermittent claudication was admitted. After laboratory and imaging investigations he underwent surgical decompression and stabilization. Histological analysis of the extracted specimen confirmed that it was gouty tophus. The patient’s symptoms improved progressively after the operation. He recovered very well with no complications.
Conclusion: The mechanism associated with axial gout is not yet clear. Obesity, inactivity, and previous degenerative disc disease may be the risk factors for spinal tophus. The clinical symptoms are diverse according to the differential localization of urate deposits. It is not easy to diagnose this disease radiographically by routine radiological examination. Analysis of a biopsy specimen is definitely the only way to confirm diagnosis. Surgical treatment should be considered in patients with spinal gout who are experiencing neurological deterioration.

Keywords: tophaceous gout, spinal gout, case report

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