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Minimally Invasive Excision of Lumbar Tophaceous Gout: Case Report.
Int J Backbone Surg. 2017;11:37
Authors: Vergara P, O’Donovan DG
Summary
Background: Symptomatic spinal gout is comparatively uncommon. Open laminectomy, with or with out fusion, has been up to now the usual therapy for symptomatic spinal gout. We describe right here the primary case of spinal tophaceus gout handled with minimally invasive surgical procedure.
Strategies: A 60-year-old affected person, morbidly overweight, with no earlier historical past of gout, offered with neurogenic claudication as a consequence of extreme lumbar canal stenosis at L3/four. Surgical procedure was carried out by means of a minimally invasive method, utilizing tubular retractors. Throughout surgical procedure, an extradural mass with a skinny capsule and containing white “chalky” partially calcified materials, barely adherent to and compressing the theca, was eliminated.
Outcomes: There have been no intra- or perioperative problems. Surgical procedure efficiently improved the useful standing, with a major enhance in strolling distance and no residual leg ache or neurogenic claudication. Histopathology confirmed the prognosis of spinal tophaceous gout.
Conclusions/Degree of proof: Though spinal gout is often attentive to medical therapy, surgical procedure is usually the primary line therapy, notably in sufferers with neurological deficits. Would surgical procedure be indicated, we consider that minimally invasive surgical procedure could be efficient in treating symptomatic spinal tophaceous gout. Degree of Proof: Class IV.
PMID: 29372141 [PubMed]