Combined Laminotomy and Spinal Endoscopic-Assisted Decompression for Gouty Tophi Involving the Lumbar Epidural Space and Multi-level Paravertebral Regions: A Case Report
Tophaceous gout involving the spinal canal is a rare but potentially debilitating condition. The study reports the case of a 41-year-old man with chronic gout who developed severe lumbar radiculopathy from extensive intraspinal epidural and multi-level paravertebral tophaceous deposits. The patient was treated with a combined procedure involving open L3–4 laminotomy and spinal endoscopic-assisted decompression to remove both intraspinal and extraspinal tophi. This strategy enabled thorough neural decompression and tophus excision while minimizing tissue disruption. Postoperatively, the patient’s neurological symptoms improved significantly. The study examines the technical nuances and benefits of integrating open and endoscopic methods for managing complex spinal gout, particularly in cases where the lesion involves multiple segments of the paravertebral region.
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