Gouty spondylodiscitis with lumbar vertebral body retrolisthesis: A case report

Rationale: Gout occurs mainly in joints, but rarely in the spine. In the spine, urate crystals can cause intervertebral space instability but rarely lead to retrolisthesis. Here, we present an extremely rare disease with gout invaded the intervertebral disc with lumbar retrolisthesis. Patient concerns: A 61-years male patient with gout history has suffered from severe low back pain and intermittent claudication. Physical examination showed the level of muscle strength of his left first toe was 3/5. Images illustrated a destruction of the intervertebral space, and a retrolisthesis at L4/5 interspace and the dural sac obviously compressed. Diagnoses: Combining with lab examinations, imaging examinations, and histopathological results, the patient was diagnosed with gouty arthritis associated with lumbar spinal stenosis, L4–5 spondylodiscitis and L4 vertebral body retrolisthesis. Intervention: The patient underwent posterior decompression, reduction, and interbody fusion, and then received an aggressive postoperative rehabilitation program. Outcomes: The patient's low back pain was significantly alleviated after the operation. Postoperative X-ray shows the internal fixation was well placed and the sequence of spine was reconstructed. 12 weeks later, the lower limb symptoms of the patients were obviously improved, his muscle strength of the left first toe was 4/5, Japanese Orthopaedic Association (JOA) score was 19 and the improvement rate was 61.5%. Lessons: G...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research