Minimally Invasive Excision of Lumbar Tophaceous Gout: Case Report

Area of Science:

• Neurosurgery
• Spinal Surgery
• Gout Management

Background:

• Symptomatic spinal gout is a rare condition.
• Open laminectomy is the traditional treatment for spinal gout.
• This study presents the first case of spinal tophaceous gout managed with minimally invasive surgery.

Purpose of the Study:

• To describe the successful application of minimally invasive surgery for spinal tophaceous gout.
• To evaluate the efficacy of minimally invasive surgery in a patient with neurogenic claudication due to spinal gout.

Main Methods:

• A 60-year-old morbidly obese patient with lumbar canal stenosis underwent surgery.
• A minimally invasive approach utilizing tubular retractors was employed.
• An extradural mass containing chalky, calcified material was removed.

Main Results:

• The surgery resulted in no intra- or perioperative complications.
• Significant improvement in functional status, walking distance, and resolution of leg pain and neurogenic claudication.
• Histopathology confirmed spinal tophaceous gout.

Conclusions:

• Minimally invasive surgery is effective for symptomatic spinal tophaceous gout.
• This approach is a potentially valuable option, especially for patients with neurological deficits.
• While medical treatment is often effective, surgery may be indicated for neurological compromise.