Chakravorty Ananya, Murambi Ronald T, Cherukuri Ravi Kumar V
J Neurosurg Spine. 2021 Mar 5;34(5):804-807. doi: 10.3171/2020.9.SPINE201010. Print 2021 May 1.
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, also known as pseudogout, is a crystalline arthropathy that usually affects large joints and periarticular tissue. Spinal involvement is rare and is usually limited to extradural articular and periarticular structures. Only one case of intradural disease has been previously reported. The authors report the second known case of intradural CPPD deposition disease. An 81-year-old man presented with an 8-week history of urinary and fecal incontinence on the background of long-standing back pain, lower-limb paresthesia, and a known L1 calcified intradural extramedullary mass. Slow growth of the L1 lesion had been documented over several decades on serial CT and MRI. A T12-L2 laminectomy and gross-total resection of the mass was performed. Histopathology demonstrated polarizing rhomboid-shaped crystals consistent with CPPD deposition disease. The patient had significant improvement in bowel and bladder function 6 months postoperatively and made a full recovery. The pathophysiology of intradural involvement remains uncertain. Further case series are required to clarify the true incidence and prognosis of the condition.
二水焦磷酸钙（CPPD）晶体沉积病，又称假痛风，是一种结晶性关节病，通常累及大关节和关节周围组织。脊柱受累罕见，通常局限于硬膜外关节和关节周围结构。此前仅报道过1例硬膜内疾病。作者报告了第二例已知的硬膜内CPPD沉积病病例。一名81岁男性，长期背痛、下肢感觉异常，已知L1节段存在硬膜内髓外钙化肿块，在此背景下出现了8周的大小便失禁病史。连续CT和MRI显示L1病变在几十年间生长缓慢。实施了T12-L2椎板切除术并对肿块进行了全切除。组织病理学显示偏振菱形晶体，符合CPPD沉积病表现。患者术后6个月肠道和膀胱功能有显著改善并完全康复。硬膜内受累的病理生理学仍不确定。需要更多病例系列来阐明该病的真实发病率和预后。
