{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:06:14Z","timestamp":1791389174880,"version":"4.3.3"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"26","license":[{"start":{"date-parts":[[2023,12,25]],"date-time":"2023-12-25T00:00:00Z","timestamp":1703462400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,25]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Tophaceous gout is a severe form of gout that results in the formation of large nodules, or tophi, in the affected joints and surrounding tissues. Gouty tophi in the spine have a constellation of presentations that often mimic other pathologies and may not be easily discernable from more common pathologic processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 47-year-old female with a history of chronic renal disease, obesity, gout, inflammatory polyarthritis, and multiple sclerosis presented with 6 months of low-back pain and lumbar radiculopathy affecting the right lower extremity. A lumbar magnetic resonance imaging study revealed right foraminal stenosis and spondylolisthesis at levels L4\u20135. An intraspinal extradural mass was noted adjacent to the traversing right L5 and exiting right L4 nerve roots. A bilateral decompressive laminectomy, facetectomy, and foraminotomy of L4\u20135 was performed. A calcific, chalky-white mass was discovered in the foramen, and pathology determined the specimen to be a gout tophus. Postoperatively, the patient endorsed the resolution of her preoperative symptoms, which have not returned on follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Reports of gouty depositions compressing the spinal cord in the current literature are relatively rare. Although the diagnosis of gouty tophi can only be confirmed histologically, patient history may serve as a helpful diagnostic tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23298","type":"journal-article","created":{"date-parts":[[2023,12,25]],"date-time":"2023-12-25T18:52:31Z","timestamp":1703530351000},"source":"Crossref","is-referenced-by-count":7,"title":["Foraminal stenosis and radiculopathy secondary to tophaceous gout: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Patrick","family":"Chang","sequence":"first","affiliation":[{"name":"College of Medicine, Drexel University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon C","family":"Rogowski","sequence":"additional","affiliation":[{"name":"College of Medicine, Drexel University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled Abdel","family":"Aziz","sequence":"additional","affiliation":[{"name":"College of Medicine, Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosh","family":"Bharthi","sequence":"additional","affiliation":[{"name":"College of Medicine, Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance","family":"Valls","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny Health Network, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Esplin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny Health Network, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny Health Network, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Nat Rev Dis Primers","first-page":"69","article-title":"Gout","volume":"5","author":"Dalbeth N","year":"2019","unstructured":"Dalbeth N, Choi HK, Joosten LAB,  Gout. Nat Rev Dis Primers. 2019;5(1):69."},{"key":"b2","series-title":"BMJ Case Rep","first-page":"bcr2017221163","article-title":"Rogue one: a story of tophaceous gout in the spine","volume":"2018","author":"Dwarki K","year":"2018","unstructured":"Dwarki K, Dothard A, Abadie B, Miles MC. Rogue one: a story of tophaceous gout in the spine. BMJ Case Rep. 2018;2018:bcr2017221163."},{"issue":"5","key":"b3","series-title":"J Bone Joint Surg Am","first-page":"767","article-title":"Gout of the spine. Two case reports and a review of the literature","volume":"77","author":"Fenton P","year":"1995","unstructured":"Fenton P, Young S, Prutis K. Gout of the spine. Two case reports and a review of the literature. J Bone Joint Surg Am. 1995;77(5):767\u2013771."},{"issue":"1","key":"b4","series-title":"Evid Based Spine Care J","first-page":"52","article-title":"A case of tophaceous gout in the lumbar spine: a review of the literature and treatment recommendations","volume":"5","author":"Jegapragasan M","year":"2014","unstructured":"Jegapragasan M, Calniquer A, Hwang WD, Nguyen QT, Child Z. A case of tophaceous gout in the lumbar spine: a review of the literature and treatment recommendations. Evid Based Spine Care J. 2014;5(1):52\u201356."},{"issue":"2","key":"b5","series-title":"Am J Emerg Med","first-page":"216","article-title":"Tophaceous lumbar gout mimicking an epidural abscess","volume":"16","author":"Gines R","year":"1998","unstructured":"Gines R, Bates DJ. Tophaceous lumbar gout mimicking an epidural abscess. Am J Emerg Med. 1998;16(2):216."},{"issue":"1","key":"b6","series-title":"Clin Infect Dis","first-page":"217","article-title":"Granulomatous tophaceous gout mimicking tuberculous tenosynovitis: report of two cases","volume":"21","author":"Kostman JR","year":"1995","unstructured":"Kostman JR, Rush P, Reginato AJ. Granulomatous tophaceous gout mimicking tuberculous tenosynovitis: report of two cases. Clin Infect Dis. 1995;21(1):217\u2013219."},{"issue":"24","key":"b7","series-title":"Spine (Phila Pa 1976)","first-page":"E1534","article-title":"Cervical cord compression due to intradiscal gouty tophus: brief report","volume":"37","author":"Sanmillan Blasco JL","year":"2012","unstructured":"Sanmillan Blasco JL, Vidal Sarro N, Marnov A, Acebes Mart\u00edn JJ. Cervical cord compression due to intradiscal gouty tophus: brief report. Spine (Phila Pa 1976). 2012;37(24):E1534\u2013E1536."},{"issue":"7","key":"b8","series-title":"J Rheumatol","first-page":"1445","article-title":"Correlates of axial gout: a cross-sectional study","volume":"39","author":"Konatalapalli RM","year":"2012","unstructured":"Konatalapalli RM, Lumezanu E, Jelinek JS, Murphey MD, Wang H, Weinstein A. Correlates of axial gout: a cross-sectional study. J Rheumatol. 2012;39(7):1445\u20131449."},{"issue":"11","key":"b9","series-title":"World J Orthop","first-page":"766","article-title":"Spinal gout: a review with case illustration","volume":"7","author":"Elgafy H","year":"2016","unstructured":"Elgafy H, Liu X, Herron J. Spinal gout: a review with case illustration. World J Orthop. 2016;7(11):766\u2013775."},{"issue":"12","key":"b10","series-title":"Curr Rheumatol Rep","first-page":"70","article-title":"Gout in the spine: imaging, diagnosis, and outcomes","volume":"17","author":"Toprover M","year":"2015","unstructured":"Toprover M, Krasnokutsky S, Pillinger MH. Gout in the spine: imaging, diagnosis, and outcomes. Curr Rheumatol Rep. 2015;17(12):70."},{"issue":"1","key":"b1","series-title":"Nat Rev Dis Primers","first-page":"69","article-title":"Gout","volume":"5","author":"Dalbeth N","year":"2019","unstructured":"Dalbeth N, Choi HK, Joosten LAB,  Gout. Nat Rev Dis Primers. 2019;5(1):69."},{"key":"b2","series-title":"BMJ Case Rep","first-page":"bcr2017221163","article-title":"Rogue one: a story of tophaceous gout in the spine","volume":"2018","author":"Dwarki K","year":"2018","unstructured":"Dwarki K, Dothard A, Abadie B, Miles MC. Rogue one: a story of tophaceous gout in the spine. 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