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KMID : 0388720220290010010
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Journal of Korean Society of Spine Surgery
2022 Volume.29 No. 1 p.10 ~ p.15
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Polyostotic Spinal Paget’s With Lumbar Kyphotic Deformity: A Case Report And Literature Review
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Vijayan Selvin Prabhakar
Gerber Christopher
Basu Anindya
Hussain Tosaddeque
Tiwari Mona
Mhatre Radhika
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Abstract
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Study Design: Case report
Objectives: Paget’s disease is a metabolic disorder of the skeletal system involving the spine commonly. Prevalence of Paget’s is uncommon in Southern Asia when compared to the West. The disease can be divided into three major phases namely lytic, mixed and a sclerotic phase. They have 2 types of clinical presentation- polyostotic or monostotic type. Blood and radiological investigations help in diagnosis. The mainstay of management is pharmacotherapy, rarely requiring surgery.
Materials and Methods: A 45 years old male, presented with back pain and claudication, initially mistreated to be a case of Pott’s spine. After investigating, he was operated because of worsening symptoms and conformation of diagnosis. Retrospective analysis of operation theatre and out patient records was done, compiled and presented.
Results: Confirmatory diagnosis of Paget’s disease was done based on histopathology. A whole body radionucleotide scan was done to rule out any other skeletal lesion. He was started on medical management for Paget’s. He improved symptomatically, during the last follow up he was asymptomatic with no clinical disability and radiological improvement of lesion.
Conclusions: Atypical presentation of Paget’s with a polyostotic spinal involvement in a South Asian is rare. High suspicion and prompt investigations help in early diagnosis and treatment. Pharmacotherapy is the mainstay of treatment with surgery when indicated.
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KEYWORD
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Pagets disease, Lumbar spine, Polyostotic, Surgery, Bisphosphonate
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