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Clinical Manifestations:

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Updated: Jun 16, 2026

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity

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Thoracic spinal cord compression by a tophus.

Honoré Ntsiba¹, Edouard Makosso, Armand Moyikoua

¹Services de rhumatologie, radiologie, CHU de Brazzaville, BP 32, Brazzaville, Congo. hntsiba@yahoo.fr

Joint Bone Spine

|February 16, 2010

Summary

Spinal cord compression caused by a tophus, a crystal deposit common in chronic gout, can lead to serious neurological issues. Surgical removal of the tophus effectively resolved symptoms in a recent case.

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Laminectomy for the Removal of Thoracic Ossification of the Ligamentum Flavum (TOLF) Using Ultrasonic and Conventional Osteotomes

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Published on: April 21, 2023

Area of Science:

Neurology
Rheumatology
Pathology

Background:

Chronic gouty arthritis is characterized by the deposition of monosodium urate crystals, forming tophi.
Tophi can occur in various locations, including the spine, potentially leading to neurological complications.
Spinal cord compression is a rare but serious manifestation of gouty tophi.

Observation:

A 43-year-old male patient with a history of chronic gout, hypertension, and alcohol abuse presented with progressive spastic paraplegia over six months.
Magnetic resonance imaging (MRI) and computed tomography (CT) revealed an intradural nodule at the T10 level, consistent with a tophus, and associated bony changes.
The intradural nodule measured 1.5 cm in diameter.

Findings:

Surgical excision of the T10 intradural nodule confirmed the histological diagnosis of a tophus.
Postoperatively, the patient experienced rapid and complete resolution of neurological deficits, including spastic paraplegia.
A literature review identified approximately 60 similar cases of spinal cord compression due to gouty tophi.

Implications:

This case highlights that spinal tophi are a treatable cause of spinal cord compression in patients with chronic gout.
Early diagnosis and surgical intervention are crucial for favorable neurological outcomes.
Rheumatologists and neurologists should consider gouty tophi in the differential diagnosis of spinal cord compression, especially in patients with a history of chronic gout.