Table 1 Clinical characters and spinal compression of the patients with tophaceous gout of the spine
Case | Age | Sex | HT of Gout (Y/N) | Serum uric acid (umol/L) | HT of symptom | Follow-up period | Clinical features | Neurological presentation | Involved vertebral level | Compression position | Treatment |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 26 | M | Y | 670 | 6 months | 2 years | Numbness of both buttocks, radiation pain of both lower limbs | Bilateral dorsalis extensor and plantar flexor strength (4/5), perianal numbness | L4–S1 | Erosion over adjacent vertebral bodies, facet articulation and lamina attachments, posterior spinal cord and nerve roots | Surgery of posterior decompression, L3–S1 fusion and fixation |
2 | 74 | M | N | / | 2 years | 5 years | Back pain, followed by both lower limbs weakness and radiation pain | Lower legs weakness (2/5), absent knee jerk reflexes, weakness of testicular reflex, anal reflex and sellar sensation | L4/5 | L4/5 facet articulation, posterior spinal cord and nerve roots | Surgery of posterior decompression, L2–L5 fusion and fixation |
3 | 76 | M | Y | 518 | 1 month | 3 years | Back pain, followed by both lower limbs radiation pain | NO | L5/S1 | Spinal cord | Surgery of posterior decompression, L5/S1 fusion and fixation |
4 | 23 | M | Y | 562 | 4 days | 3 years | Neck occipital pain | NO | C1/2 | Atlantoaxial pathological fracture | Posterior atlantoaxial iliac bone graft fusion and internal fixation |
5 | 65 | M | Y | 542 | 2 months | 4 years | Back pain, followed by both lower limbs weakness and radiation pain | Left dorsalis extensor strength (4/5), weakness of testicular reflex, anal reflex and sellar sensation | L4/5 | Erosion over adjacent vertebral bodies, facet articulation and lamina attachments, posterior spinal cord and nerve roots | Surgery of posterior decompression, L4–S1 fusion and fixation |
6 | 39 | M | Y | 558 | 1 month | 2 years | Back pain, followed by both lower limbs radiation pain | Bilateral lower limbs numbness, maximum temperature: 39.8◦C | L4–S1 | Erosion over L4–S1 left adjacent vertebral bodies, facet articulation and lamina attachments, posterior spinal cord and nerve roots | Surgery of posterior decompression, L4–S1 fusion and fixation |
7 | 65 | M | N | / | 10 days | 3 years | Back pain, followed by both lower limbs radiation pain | Decreased skin sensation of right lower limb | L3–L5 | Gout stones scattered between L3/4 and L4/5 interspinous ligaments, ligamentum flavum and annulus fibrosus, posterior spinal cord | Surgery of posterior decompression, L3–L5 fusion and fixation |