文献类型：期刊文献

英文题名：Nerve root compression due to lumbar spinal canal tophi A case report and review of the literature

作者：Wang, Kai[1];Yang, Quan-Zeng[2];Wen, Hao-Nan[1];Hai, Yun-Xaing[1];Gao, Guo-Dong[2];Song, Min[1,2]

第一作者：王恺

通信作者：Song, M[1]

机构：[1]Gansu Univ Chinese Med, Clin Coll Chinese Med, Lanzhou, Gansu, Peoples R China;[2]Affiliated Hosp Gansu Univ Chinese Med, Dept Orthoped, Lanzhou, Gansu, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Clin Coll Chinese Med, Lanzhou, Gansu, Peoples R China.|[10735]甘肃中医药大学;

年份：2022

卷号：101

期号：45

起止页码：e31562

外文期刊名：MEDICINE

收录：;Scopus(收录号：2-s2.0-85142156495);WOS:【SCI-EXPANDED(收录号:WOS:000898398700073)】；

语种：英文

外文关键词：case report; gout; literature review; lumbar spine; uric acid

摘要：Rationale: Gout in the spine and adnexa is rare in clinical practice and can also be easily misdiagnosed, we reported a patient with nerve root compression due to lumbar gout stones in the lumbar spinal canal. Patient concerns: A 51-year-old male was admitted to the hospital with lumbar pain with numbness in the left lower limb for more than 6 months. The physical examination showed that tenderness and percussion pain were present at L4-S1 spinous process. Straight leg raise test: 50 degrees on the left side were positive. Laboratory tests showed that the sUA was 669 mu mol/L, MRI of the lumbar spine showed that cystic T1WI low signal and T2WI mixed high signal shadows were seen in the spinal canal at the level of L4-L5. Diagnoses: Combining with lab examinations, imaging examinations, and histopathological results, the patient was diagnosed with lumbar spinal canal tophi. Interventions: After active improvement of all examinations, the patient underwent surgical treatment with decompression and internal fixation of the L4-L5 segment. Outcomes: After surgery, the patient's symptoms improved and muscle strength returned to normal. Among the 95 previously reported patients with lumbar gout, the ratio of men to women was 2.96:1, and the peak age group of incidence was 56 to 65 years. The onset of the disease was mainly in a single segment of the lumbar spine, with 34.41% of all cases occurring at the L4-L5 level. 61.05% of the patients had a history of gout attacks or hyperuricemia, and the most frequently involved site was the foot and ankle, followed by the wrist. Sixty-seven patients underwent surgical treatment, and 22 chose conservative treatment, with overall satisfactory results. Lessons subsections: The incidence of lumbar gout is low and relatively rare in the clinic and pathological biopsy is still the gold standard. Vertebral plate incision and decompression are often selected for surgical treatment, and whether to perform fusion should be comprehensively considered for the destruction of vertebral bone by gout and the reasonable selection of the extent of surgical resection. Whether choosing surgical treatment or conservative therapy, the control of uric acid levels should be emphasized.