Cervical cord compression due to intradiscal gouty tophus: brief report

• Published in: Spine (Philadelphia, Pa. 1976) Vol. 37; no. 24; p. E1534
• Main Authors: Sanmillan Blasco, Jose Luis, Vidal Sarro, Noemi, Marnov, Alexei, Acebes Martín, Juan José
• Format: Journal Article
• Language: English
• Published: United States 15.11.2012
• Subjects: Aged; Cervical Vertebrae - pathology; Cervical Vertebrae - surgery; Decompression, Surgical; Gout - complications; Gout - pathology; Gout - surgery; Humans; Intervertebral Disc - pathology; Intervertebral Disc - surgery; Male; Spinal Cord Compression - etiology; Spinal Cord Compression - pathology; Spinal Cord Compression - surgery; Spinal Fusion; Treatment Outcome
• ISSN: 1528-1159
• DOI: 10.1097/BRS.0b013e31826f2886

We describe an unusual cause of myelopathy with a discussion of similar cases previously reported in the literature. To report a case of myelopathy due to intradiscal gouty tophus. Spinal involvement in gout is uncommon. Cervical spinal cord compression caused by gout is particularly rare. We report the case of a 71-year-old man with a history of hyperuricemia gout. Spastic quadriparesis developed for more than 4 months. Magnetic resonance image of the cervical spine revealed a herniated cervical disc at the C3-C4 level. Anterior discectomy was performed. Intradiscal chalky white granular material was found during surgery. Histological examination of the surgical specimen demonstrated a gouty tophus. The patient regained strength in all extremities in the postoperative period and required rehabilitation treatment. Spinal gout should be considered in all patients presenting myelopathy and history of gout. When progressive neurological symptoms develop, surgical decompression can provide a satisfactory outcome.