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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