Lu Huigen, Sheng Jianming, Dai Jiaping, Hu Xuqi
Department of Orthopaedics, The Second Hospital of Jiaxing, Jiaxing, China.
Medicine (Baltimore). 2017 Aug;96(32):e7670. doi: 10.1097/MD.0000000000007670.
Gout in the spine is very rare. The clinical symptoms of the spinal gout are various and lack of specificity. The authors report a case of spinal gout causing lumbar stenosis. We never find such wide-invasive spinal gouty lesion in the published studies.
A 68-year-old male had low back pain radiating to bilateral lower limbs, accompanying with intermittent claudication that lasted for 3 months and aggravated 5 days ago.
Spinal gout, lumbar stenosis.
The patient underwent L2-L4 laminectomy, L2/3 L3/4 an d L4/5 discectomy and transforaminal lumbar interbody fusion with pedicle screw fixation.
Dual-energy computed tomography detected extensive tophaceous deposits in L1/2 L2/3 L3/4 and L4/5 lumbar discs as well as the posterior column, especially L2-L3 and L4-L5 facet joints. During the surgery, we found a mass of chalky white material at the posterior column of L3 to L5 vertebral bodies, which also involved the intervertebral discs. Pathological examination confirmed the diagnosis of spinal gout.
Although spinal gout is thought to be rare, the diagnosis should be considered if the patient had severe back pain and a history of gout. Dual-energy computed tomography is highly recommended for these patients.
脊柱痛风非常罕见。脊柱痛风的临床症状多样且缺乏特异性。作者报告了一例导致腰椎管狭窄的脊柱痛风病例。在已发表的研究中，我们从未发现如此广泛侵袭性的脊柱痛风性病变。
一名68岁男性出现下背部疼痛并放射至双侧下肢，伴有间歇性跛行，持续3个月，5天前加重。
脊柱痛风，腰椎管狭窄。
患者接受了L2-L4椎板切除术、L2/3、L3/4和L4/5椎间盘切除术以及经椎间孔腰椎椎体间融合术并椎弓根螺钉固定。
双能计算机断层扫描在L1/2、L2/3、L3/4和L4/5腰椎间盘以及后柱，尤其是L2-L3和L4-L5小关节处检测到广泛的痛风石沉积。手术中，我们在L3至L5椎体的后柱发现了一团灰白色物质，其也累及椎间盘。病理检查证实了脊柱痛风的诊断。
尽管脊柱痛风被认为很罕见，但如果患者有严重的背痛和痛风病史，应考虑进行诊断。强烈建议对这些患者进行双能计算机断层扫描。
