Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10647
Peer-review started: April 14, 2022
First decision: June 16, 2022
Revised: June 26, 2022
Accepted: September 1, 2022
Article in press: September 1, 2022
Published online: October 16, 2022
Processing time: 167 Days and 15.8 Hours
Spinal gout (SG) is a rare condition. So far, a limited number of cases have been reported. Herein, we reported a single case of a 42-year-old male patient with SG involving the cervicothoracic and lumbar spine who underwent cervicothoracic segmental surgery.
The patient presented to the hospital with neck pain and limb weakness lasting for one month. He had a history of gout for more than 10 years. Clinical and imaging findings indicated bone and joint tophus erosion, and the patient underwent standard tophi excision and internal fixation with a nail-and-rod system. Histopathological examination suggested gout-like lesions. After the operation, the patient’s spinal nerve symptoms disappeared, and muscle strength gradually returned to normal. The patient maintained a low-purine diet and was recommended to engage in healthy exercises. The patient recovered well.
Clinicians should highly suspect SG when patients with chronic gout presented with low back pain and neurological symptoms. Early decompression and debridement surgery are important to relieve neurological symptoms and prevent severe secondary neurological deficits.
Core Tip: Spinal gout (SG) is a rare condition. This case report described the full course of surgical management of a SG patient. After surgical treatment, the patient’s symptoms were alleviated and the radiological findings improved. The case report highlighted the importance of surgical management of SG with neurological symptoms and presented a rare case of whole-spinal tophus deposition.