Clinical observation of posterior decompression, fusion and fixation in the treatment of spinal gout: a case series
Abstract Objective The aim of the present study was to assess the effect of posterior decompression, fusion and fixation in the treatment of spinal gout. Spinal gout is a disease of gouty arthritis involving the spine, which can affect all segments of the spine. At present, the etiology and pathogen...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03791-9 |
| _version_ | 1827966180280762368 |
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| author | M. M. Xingmao Zhou M. M. Minhua Wu M. M. Lili Sang M. M. Junzhe Wu |
| author_facet | M. M. Xingmao Zhou M. M. Minhua Wu M. M. Lili Sang M. M. Junzhe Wu |
| author_sort | M. M. Xingmao Zhou |
| collection | DOAJ |
| description | Abstract Objective The aim of the present study was to assess the effect of posterior decompression, fusion and fixation in the treatment of spinal gout. Spinal gout is a disease of gouty arthritis involving the spine, which can affect all segments of the spine. At present, the etiology and pathogenesis of spinal gout are not clear, and there are no definite methods for the treatment of spinal gout. Methods This was a case series of seven patients (seven men) who underwent posterior decompression, fusion and fixation in the treatment of spinal gout 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 effect of this procedure. All patients were followed up every 3 months. The evaluation time point was 12 months after the operation. Comparisons of the functional indexes of the patients before and after the operation were performed using SPSS 22.0 (IBM, Armonk, NY, USA). Results The JOA score was 13.43 ± 6.55 and the VAS score was 7.43 ± 1.51 preoperatively. The JOA score was 24.43 ± 3.74 and the VAS score was 0.86 ± 0.90 postoperatively at 12 months after surgery. At 12 months after surgery, the JOA and VAS score showed significant improvements when compared with those before surgery (P = 0.004 and P = 0.002, respectively). None of the patients had re-surgery of the gout due to actively and reasonably controlling uric acid. No loosening or displacement of screws was reported. There was only one screw tail cap loosening. Radiographic examination revealed that there was no obvious accumulation of gout or surrounding bone destruction, and the segmental instability was significantly improved. There was no progressive aggravation of neurological symptoms of the seven patients. Conclusions Posterior approach decompression, fusion and fixation can stabilize the vertebral body, remove gout and directly relieve local spinal cord compression. The method is a reliable surgical choice for the treatment of spinal gout. |
| first_indexed | 2024-04-09T17:45:55Z |
| format | Article |
| id | doaj.art-4b7c769df2a2437a9d0b8df11ddc763a |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-09T17:45:55Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-4b7c769df2a2437a9d0b8df11ddc763a2023-04-16T11:20:08ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-04-011811910.1186/s13018-023-03791-9Clinical observation of posterior decompression, fusion and fixation in the treatment of spinal gout: a case seriesM. M. Xingmao Zhou0M. M. Minhua Wu1M. M. Lili Sang2M. M. Junzhe Wu3Department of Orthopaedic Surgery, Zhongshan Hospital of Traditional Chinese MedicineDepartment of Orthopaedic Surgery, Zhongshan Hospital of Traditional Chinese MedicineDepartment of Orthopaedic Surgery, Zhongshan Hospital of Traditional Chinese MedicineDepartment of Orthopaedic Surgery, Zhongshan Hospital of Traditional Chinese MedicineAbstract Objective The aim of the present study was to assess the effect of posterior decompression, fusion and fixation in the treatment of spinal gout. Spinal gout is a disease of gouty arthritis involving the spine, which can affect all segments of the spine. At present, the etiology and pathogenesis of spinal gout are not clear, and there are no definite methods for the treatment of spinal gout. Methods This was a case series of seven patients (seven men) who underwent posterior decompression, fusion and fixation in the treatment of spinal gout 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 effect of this procedure. All patients were followed up every 3 months. The evaluation time point was 12 months after the operation. Comparisons of the functional indexes of the patients before and after the operation were performed using SPSS 22.0 (IBM, Armonk, NY, USA). Results The JOA score was 13.43 ± 6.55 and the VAS score was 7.43 ± 1.51 preoperatively. The JOA score was 24.43 ± 3.74 and the VAS score was 0.86 ± 0.90 postoperatively at 12 months after surgery. At 12 months after surgery, the JOA and VAS score showed significant improvements when compared with those before surgery (P = 0.004 and P = 0.002, respectively). None of the patients had re-surgery of the gout due to actively and reasonably controlling uric acid. No loosening or displacement of screws was reported. There was only one screw tail cap loosening. Radiographic examination revealed that there was no obvious accumulation of gout or surrounding bone destruction, and the segmental instability was significantly improved. There was no progressive aggravation of neurological symptoms of the seven patients. Conclusions Posterior approach decompression, fusion and fixation can stabilize the vertebral body, remove gout and directly relieve local spinal cord compression. The method is a reliable surgical choice for the treatment of spinal gout.https://doi.org/10.1186/s13018-023-03791-9Spinal goutPosterior decompressionFusion and fixationClinical effect |
| spellingShingle | M. M. Xingmao Zhou M. M. Minhua Wu M. M. Lili Sang M. M. Junzhe Wu Clinical observation of posterior decompression, fusion and fixation in the treatment of spinal gout: a case series Journal of Orthopaedic Surgery and Research Spinal gout Posterior decompression Fusion and fixation Clinical effect |
| title | Clinical observation of posterior decompression, fusion and fixation in the treatment of spinal gout: a case series |
| title_full | Clinical observation of posterior decompression, fusion and fixation in the treatment of spinal gout: a case series |
| title_fullStr | Clinical observation of posterior decompression, fusion and fixation in the treatment of spinal gout: a case series |
| title_full_unstemmed | Clinical observation of posterior decompression, fusion and fixation in the treatment of spinal gout: a case series |
| title_short | Clinical observation of posterior decompression, fusion and fixation in the treatment of spinal gout: a case series |
| title_sort | clinical observation of posterior decompression fusion and fixation in the treatment of spinal gout a case series |
| topic | Spinal gout Posterior decompression Fusion and fixation Clinical effect |
| url | https://doi.org/10.1186/s13018-023-03791-9 |
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