Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10647-10654
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10647
Multiple tophi deposits in the spine: A case report
Hua-Jian Chen, De-Yuan Chen, Shao-Zhen Zhou, Ke-De Chi, Jun-Ze Wu, Fu-Li Huang
Hua-Jian Chen, Shao-Zhen Zhou, Graduate School, Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Hua-Jian Chen, De-Yuan Chen, Shao-Zhen Zhou, Ke-De Chi, Jun-Ze Wu, Fu-Li Huang, Department One of Spinal Surgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan 528400, Guangdong Province, China
Author contributions: Chen HJ and Huang FL were responsible for the conception and design; Chen HJ and Chen DY were responsible for manuscript writing and revision; Zhou SZ, Wu JZ and Chi KD participated in the data analysis; and all authors read and approved the final manuscript.
Supported by Zhongshan Science and Technology Bureau, No. 210329183949251.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Fu-Li Huang, MMed, Chief Doctor, Surgeon, Teacher, Department One of Spinal Surgery, Zhongshan Hospital of Traditional Chinese Medicine, No. 3 Kangxin Road, West District, Zhongshan 528400, Guangdong Province, China.
Received: April 14, 2022
Peer-review started: April 14, 2022
First decision: June 16, 2022
Revised: June 26, 2022
Accepted: September 1, 2022
Article in press: September 1, 2022
Published online: October 16, 2022
Processing time: 167 Days and 15.8 Hours

Spinal gout (SG) is a rare condition. So far, a limited number of cases have been reported. Herein, we reported a single case of a 42-year-old male patient with SG involving the cervicothoracic and lumbar spine who underwent cervicothoracic segmental surgery.


The patient presented to the hospital with neck pain and limb weakness lasting for one month. He had a history of gout for more than 10 years. Clinical and imaging findings indicated bone and joint tophus erosion, and the patient underwent standard tophi excision and internal fixation with a nail-and-rod system. Histopathological examination suggested gout-like lesions. After the operation, the patient’s spinal nerve symptoms disappeared, and muscle strength gradually returned to normal. The patient maintained a low-purine diet and was recommended to engage in healthy exercises. The patient recovered well.


Clinicians should highly suspect SG when patients with chronic gout presented with low back pain and neurological symptoms. Early decompression and debridement surgery are important to relieve neurological symptoms and prevent severe secondary neurological deficits.

Keywords: Spinal gout, Surgery, Uric acid, Dual-energy computed tomography, Case report

Core Tip: Spinal gout (SG) is a rare condition. This case report described the full course of surgical management of a SG patient. After surgical treatment, the patient’s symptoms were alleviated and the radiological findings improved. The case report highlighted the importance of surgical management of SG with neurological symptoms and presented a rare case of whole-spinal tophus deposition.