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2016 ; 7
(11
): 766-775
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Spinal gout: A review with case illustration
#MMPMID27900275
Elgafy H
; Liu X
; Herron J
World J Orthop
2016[Nov]; 7
(11
): 766-775
PMID27900275
show ga
AIM: To summarize clinical presentations and treatment options of spinal gout in
the literature from 2000 to 2014, and present theories for possible mechanism of
spinal gout formation. METHODS: The authors reviewed 68 published cases of spinal
gout, which were collected by searching "spinal gout" on PubMed from 2000 to
2014. The data were analyzed for clinical features, anatomical location of spinal
gout, laboratory studies, imaging studies, and treatment choices. RESULTS: Of the
68 patients reviewed, the most common clinical presentation was back or neck pain
in 69.1% of patients. The most common laboratory study was elevated uric acid
levels in 66.2% of patients. The most common diagnostic image finding was
hypointense lesion of the gout tophi on the T1-weighted magnetic resonance
imaging scan. The most common surgical treatment performed was a laminectomy in
51.5% and non-surgical treatment was performed in 29.4% of patients. CONCLUSION:
Spinal gout most commonly present as back or neck pain with majority of reported
patients with elevated uric acid. The diagnosis of spinal gout is confirmed with
the presence of negatively birefringent monosodium urate crystals in tissue.
Treatment for spinal gout involves medication for the reduction of uric acid
level and surgery if patient symptoms failed to respond to medical treatment.
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