Endoscopic management of lumbar spinal tophaceous gout: six cases treated with percutaneous transforaminal (PTED) and interlaminar (PIED) discectomy and a literature review.

BACKGROUND

Gout is a metabolic disorder caused by the deposition of urate crystals in the joints and surrounding tissues. Prolonged hyperuricemia leads to the formation and accumulation of urate crystals, often resulting in acute and chronic joint damage. Spinal gout is a rare type caused by the deposition of urate crystals in spinal tissues. It leads to local inflammation, pain, and, in severe cases, neurological symptoms. The clinical presentation of spinal gout is varied and lacks specificity, making it easily confused with other spinal disorders, especially in elderly patients.

METHODS

We report six rare lumbar disc deposits caused by tophi (gout stones). The main symptoms in these patients were lower back pain accompanied by leg pain and/or numbness. All patients underwent surgical treatment with satisfactory outcomes. We also provide a brief review of the relevant literature on spinal gout.

RESULTS

This article discusses the pathophysiological mechanisms, clinical manifestations, imaging characteristics, diagnosis, and treatment strategies for spinal gout. The goal is to enhance clinicians' awareness of spinal gout, and enable early detection, diagnosis, and treatment.