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[Spinal localization of Paget disease--case report]
Srpski Arhiv Za Celokupno Lekarstvo
|October 31, 2008
Summary
Paget disease affecting the thoracic spine presents diagnostic and treatment challenges. Early consideration of this spinal condition, combined with medical and surgical interventions, can improve neurological outcomes.
Area of Science:
- Orthopedics
- Neurology
- Endocrinology
Background:
- Paget disease localized to the thoracic vertebrae poses diagnostic and treatment challenges.
- It requires comprehensive radiological, neurological, and endocrinological evaluation due to progressive neurological symptoms.
- Treatment may involve medication and surgical decompression of nerve elements.
Observation:
- A case of an older male with chronic progressive pain in the thoracic vertebrae and leg muscle hypertonus is presented.
- Initial vertebral biopsy suggested parathyroid disturbance, later excluded by endocrinological analyses.
- Surgical intervention included corporectomy and spondylodesis, with initial neurological improvement.
Findings:
- Pathological findings confirmed Paget disease of the vertebrae.
- A relapse occurred 2.5 years post-surgery, leading to gibbus deformity.
- Two-stage surgical treatment (decompression and laminectomy) resulted in partial neurological recovery.
Implications:
- Spinal Paget disease, even in its monoostotic form, should be considered in progressive neurological impairment with biochemical and radiological abnormalities.
- A combined approach of medical management and surgical treatment is crucial for improving neurological function.
- This case highlights the complexity and potential for relapse in spinal Paget disease, emphasizing the need for vigilant monitoring and tailored treatment strategies.