Credit: Original article published here.
Spinal gout is a rare form of gouty arthritis that affects the spine, with no definite methods for its treatment. However, a recent study in the Journal of Orthopaedic Surgery and Research aimed to assess the effectiveness of posterior decompression, fusion, and fixation in treating spinal gout.
“Due to the absence of gout nodules on the body surface, spinal gout usually does not have the typical clinical manifestations of peripheral gouty arthritis, and its symptoms and imaging manifestations are easy to be confused with tumors, infections, and other diseases,” the researchers wrote, “so there is a lack of effective diagnosis and treatment measures and standards, which brings difficulties to the diagnosis and treatment of spinal gout.”
Researchers conducted a case series of 7 male patients who underwent this procedure between January 2016 and January 2020. Physical examination, radiography, CT, MRI, Japanese Orthopaedic Association (JOA) score, and visual analog scale (VAS) score were used to evaluate the effectiveness of the treatment, with a follow-up at 12 months after the operation.
The results of the study showed that the JOA score improved significantly from 13.43 preoperatively to 24.43 postoperatively (P=.004). The VAS score also improved significantly from 7.43 preoperatively to 0.86 postoperatively. None of the patients required re-surgery of the gout due to controlling uric acid. Moreover, no screw displacement was reported, and radiographic examination revealed no accumulation of gout or surrounding bone destruction. Additionally, segmental instability was significantly improved, and no progressive aggravation of neurological symptoms of the 7 patients was observed.
The study had several limitations, as noted by the authors: “This is a descriptive and retrospective analysis, with the inclusion of a small sample size due to a single-center study.”
Researchers concluded that “posterior decompression, fusion, and fixation can effectively reduce the compression of spinal gout at the operative level. In terms of treatment mechanism, it can stabilize the vertebral body, remove gout, and directly relieve the compression of spinal cord. It is an effective means to treat spinal gout.”
Source: Journal of Orthopaedic Surgery and Research
