Discover how a rare case of gout-induced cervical deformity, often mistaken for an infection, led to progressive myelopathy and the intricate neurosurgical reconstruction required to address this debilitating condition.
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Gout-Induced Cervical Deformity and Progressive Myelopathy Mimicking Infection Requiring Cervical Reconstruction.
Louie et al., World Neurosurg 2023
DOI: 10.1016/j.wneu.2023.11.103
Novel Presentation of Gout as Cervical Kyphotic Deformity with Myelopathy
A unique case of gout presenting as a severe cervical kyphotic deformity was reported in a 56-year-old female, who initially showed symptoms of jaw pain and a TMJ abscess, along with balance issues and tingling in the arms and hands. The condition was initially suspected to be an infection due to the presence of a severe cervical deformity with bony erosion. However, after an urgent surgical intervention involving cervical decompression, fusion, and deformity correction, the true cause was identified as gout. Pathological analysis revealed macrophages with urate crystals, indicative of gouty tophus.
What’s New: This case is the first documented instance of gout causing severe cervical deformity and myelopathy, expanding the understanding of gout’s potential impact on spinal health.
Importance: It highlights the need for clinicians to consider gout in differential diagnoses for spinal pathologies, even when symptoms are not typical of the condition.
Contribution to Literature: The successful management of this case with a 540-degree surgical approach provides a precedent for treating similar rare and complex presentations of gout, demonstrating significant improvement in the patient’s symptoms and quality of life at the two-year follow-up.