{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:28:51Z","timestamp":1769729331992,"version":"3.49.0"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,7,22]]},"abstract":"\n BACKGROUND<\/jats:title>\n Paget\u2019s disease of bone (PDB) is a common bone metabolic pathology in older adults, characterized by mixed osteolytic, osteoblastic, and quiescent periods. Surgical guidelines for PDB involving the spine are not well-defined and are reserved for cases refractory to medical treatments, typically bisphosphonates like zoledronic acid. This case study describes a 52-year-old male with PDB who presented with rapidly progressing myelopathy symptoms refractory to standard medical treatment, warranting surgical decompression.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n Surgical decompression and fusion, involving laminectomy with partial facetectomies, placement of pedicle screw instrumentation, and posterolateral arthrodesis spanning beyond the pathological segment, was performed. Follow-up visits indicated progressive improvement in symptoms and mobility, and imaging showed stable postsurgical changes with increased sclerosis in the affected vertebrae on a 2-year postsurgical course.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case underscores that PDB of the spine can transition from asymptomatic to significant impairment and demonstrates that surgical intervention can provide effective symptomatic relief in myelopathy secondary to PDB. The case contributes to the growing evidence of the effectiveness of surgical decompression in PDB involving the spine.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24203<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24203","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T01:49:06Z","timestamp":1721785746000},"source":"Crossref","is-referenced-by-count":0,"title":["Surgical decompression in spinal Paget\u2019s disease: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Anthony","family":"Price","sequence":"first","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Texas"},{"name":"Department of Neurosurgery, The University of Texas Medical Branch at Galveston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"File","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch at Galveston, Texas"},{"name":"Department of Neurosurgery, The University of Texas Medical Branch at Galveston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Call-Orellana","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romulo Augusto","family":"Andrade de Almeida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert Y","family":"North","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"bib1","series-title":"Ther Adv Musculoskelet Dis","first-page":"107","article-title":"Paget\u2019s disease of bone: a review of epidemiology, pathophysiology and management","volume":"1","author":"Shaker","year":"2009","unstructured":"Shaker JL. Paget\u2019s disease of bone: a review of epidemiology, pathophysiology and management. Ther Adv Musculoskelet Dis. 2009;1(2):107-125."},{"issue":"12","key":"bib2","series-title":"J Clin Endocrinol Metab","first-page":"4408","article-title":"Paget\u2019s disease of bone: an endocrine society clinical practice guideline","volume":"99","author":"Singer","year":"2014","unstructured":"Singer FRBone HGHosking DJ, et al. Paget\u2019s disease of bone: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(12):4408-4422."},{"issue":"4","key":"bib3","series-title":"Radiol Clin North Am","first-page":"561","article-title":"Imaging of Paget\u2019s disease of bone","volume":"60","author":"Lombardi","year":"2022","unstructured":"Lombardi AFAihara AYFernandes da ADRCCardoso FN. Imaging of Paget\u2019s disease of bone. Radiol Clin North Am. 2022;60(4):561-573."},{"issue":"1-2","key":"bib4","series-title":"Wien Med Wochenschr","first-page":"9","article-title":"Imaging of Paget\u2019s disease of bone","volume":"167","author":"Winn","year":"2017","unstructured":"Winn NLalam RCassar-Pullicino V. Imaging of Paget\u2019s disease of bone. Wien Med Wochenschr. 2017;167(1-2):9-17."},{"issue":"3","key":"bib5","series-title":"Best Pract Res Clin Rheumatol","first-page":"101506","article-title":"The evaluation and treatment of Paget\u2019s disease of bone","volume":"34","author":"Singer","year":"2020","unstructured":"Singer FR. The evaluation and treatment of Paget\u2019s disease of bone. Best Pract Res Clin Rheumatol. 2020;34(3):101506."},{"issue":"5","key":"bib6","series-title":"Eur Radiol","first-page":"1005","article-title":"Dynamic contrast-enhanced MRI in Paget\u2019s disease of bone\u2014correlation of regional microcirculation and bone turnover","volume":"18","author":"Libicher","year":"2008","unstructured":"Libicher MKasperk CDaniels MHosch WKauczor HUDelorme S. Dynamic contrast-enhanced MRI in Paget\u2019s disease of bone\u2014correlation of regional microcirculation and bone turnover. Eur Radiol. 2008;18(5):1005-1011."},{"issue":"5","key":"bib7","series-title":"Eur Spine J","first-page":"370","article-title":"Paget\u2019s disease of the spine and its management","volume":"10","author":"Hadjipavlou","year":"2001","unstructured":"Hadjipavlou AGGaitanis LNKatonis PGLander P. Paget\u2019s disease of the spine and its management. Eur Spine J. 2001;10(5):370-384."},{"issue":"4","key":"bib8","series-title":"J Bone Miner Res","first-page":"579","article-title":"Diagnosis and management of Paget\u2019s disease of bone in adults: a clinical guideline","volume":"34","author":"Ralston","year":"2019","unstructured":"Ralston SHCorral-Gudino LCooper C, et al. Diagnosis and management of Paget\u2019s disease of bone in adults: a clinical guideline. J Bone Miner Res. 2019;34(4):579-604."},{"issue":"1","key":"bib9","series-title":"Eur J Orthop Surg Traumatol","first-page":"27","article-title":"Surgical treatment in spine Paget\u2019s disease: a systematic review","volume":"26","author":"Jorge-Mora","year":"2016","unstructured":"Jorge-Mora AAmhaz-Escanlar SLois-Iglesias ALeborans-Eiris SPino-Minguez J. Surgical treatment in spine Paget\u2019s disease: a systematic review. Eur J Orthop Surg Traumatol. 2016;26(1):27-30."},{"issue":"10","key":"bib10","series-title":"J Orthop Case Rep","first-page":"1","article-title":"A polyostotic Paget\u2019s disease involving lumbar spine presenting with cauda equina syndrome: an unusual entity","volume":"11","author":"Hadgaonkar","year":"2021","unstructured":"Hadgaonkar SPatwardhan SBhilare PSancheti PShyam A. A polyostotic Paget\u2019s disease involving lumbar spine presenting with cauda equina syndrome: an unusual entity. J Orthop Case Rep. 2021;11(10):1-5."},{"issue":"12","key":"bib11","series-title":"Eur Spine J","first-page":"3066","article-title":"Paget\u2019s disease of the lumbar spine: decompressive surgery following 17 years of bisphosphonate treatment","volume":"27","author":"Hofmann","year":"2018","unstructured":"Hofmann AOpitz SHeyde CEvon der H\u00f6h NH. Paget\u2019s disease of the lumbar spine: decompressive surgery following 17 years of bisphosphonate treatment. Eur Spine J. 2018;27(12):3066-3070."},{"issue":"suppl","key":"bib12","series-title":"J Bone Miner Res","first-page":"34","article-title":"Surgical management of Paget\u2019s disease","volume":"14","author":"Kaplan","year":"1999","unstructured":"Kaplan FS. Surgical management of Paget\u2019s disease. J Bone Miner Res. 1999;14(suppl 2):34-38."},{"issue":"8","key":"bib13","series-title":"Clin Case Rep","first-page":"e6263","article-title":"Spinal Paget\u2019s disease with bilevel cord compression and ischemic non-compressive myelopathy treated with zoledronic acid","volume":"10","author":"Feki","year":"2022","unstructured":"Feki ASellami IGassara Z, et al. Spinal Paget\u2019s disease with bilevel cord compression and ischemic non-compressive myelopathy treated with zoledronic acid. Clin Case Rep. 2022;10(8):e6263."},{"issue":"3","key":"bib14","series-title":"Eur Spine J","first-page":"453","article-title":"Skeletal dissemination in Paget\u2019s disease of the spine","volume":"27","author":"Rolvien","year":"2018","unstructured":"Rolvien TButscheidt SZustin JAmling M. Skeletal dissemination in Paget\u2019s disease of the spine. Eur Spine J. 2018;27(3)(suppl 3):453-457."},{"issue":"2","key":"bib15","series-title":"Can J Surg","first-page":"140","article-title":"Strut allograft invasion by Paget\u2019s disease of bone: a case report","volume":"43","author":"Cameron","year":"2000","unstructured":"Cameron HUFornasier VLVan Zyl DV. Strut allograft invasion by Paget\u2019s disease of bone: a case report. Can J Surg. 2000;43(2):140-141."},{"issue":"1","key":"bib16","series-title":"Z Orthop Ihre Grenzgeb","first-page":"47","article-title":"Das Fortschreiten eines M. Paget in der Wirbels\u00e4ule 10 Jahre nach einer posterolateralen Spondylodese.","volume":"127","author":"Hopf","year":"1989","unstructured":"Hopf CHahn K. Das Fortschreiten eines M. Paget in der Wirbels\u00e4ule 10 Jahre nach einer posterolateralen Spondylodese.Z Orthop Ihre Grenzgeb. 1989;127(1):47-50."},{"issue":"2","key":"bib1","series-title":"Ther Adv Musculoskelet Dis","first-page":"107","article-title":"Paget\u2019s disease of bone: a review of epidemiology, pathophysiology and management","volume":"1","author":"Shaker","year":"2009","unstructured":"Shaker JL. Paget\u2019s disease of bone: a review of epidemiology, pathophysiology and management. Ther Adv Musculoskelet Dis. 2009;1(2):107-125."},{"issue":"12","key":"bib2","series-title":"J Clin Endocrinol Metab","first-page":"4408","article-title":"Paget\u2019s disease of bone: an endocrine society clinical practice guideline","volume":"99","author":"Singer","year":"2014","unstructured":"Singer FRBone HGHosking DJ, et al. Paget\u2019s disease of bone: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(12):4408-4422."},{"issue":"4","key":"bib3","series-title":"Radiol Clin North Am","first-page":"561","article-title":"Imaging of Paget\u2019s disease of bone","volume":"60","author":"Lombardi","year":"2022","unstructured":"Lombardi AFAihara AYFernandes da ADRCCardoso FN. Imaging of Paget\u2019s disease of bone. Radiol Clin North Am. 2022;60(4):561-573."},{"issue":"1-2","key":"bib4","series-title":"Wien Med Wochenschr","first-page":"9","article-title":"Imaging of Paget\u2019s disease of bone","volume":"167","author":"Winn","year":"2017","unstructured":"Winn NLalam RCassar-Pullicino V. Imaging of Paget\u2019s disease of bone. Wien Med Wochenschr. 2017;167(1-2):9-17."},{"issue":"3","key":"bib5","series-title":"Best Pract Res Clin Rheumatol","first-page":"101506","article-title":"The evaluation and treatment of Paget\u2019s disease of bone","volume":"34","author":"Singer","year":"2020","unstructured":"Singer FR. The evaluation and treatment of Paget\u2019s disease of bone. Best Pract Res Clin Rheumatol. 2020;34(3):101506."},{"issue":"5","key":"bib6","series-title":"Eur Radiol","first-page":"1005","article-title":"Dynamic contrast-enhanced MRI in Paget\u2019s disease of bone\u2014correlation of regional microcirculation and bone turnover","volume":"18","author":"Libicher","year":"2008","unstructured":"Libicher MKasperk CDaniels MHosch WKauczor HUDelorme S. Dynamic contrast-enhanced MRI in Paget\u2019s disease of bone\u2014correlation of regional microcirculation and bone turnover. Eur Radiol. 2008;18(5):1005-1011."},{"issue":"5","key":"bib7","series-title":"Eur Spine J","first-page":"370","article-title":"Paget\u2019s disease of the spine and its management","volume":"10","author":"Hadjipavlou","year":"2001","unstructured":"Hadjipavlou AGGaitanis LNKatonis PGLander P. Paget\u2019s disease of the spine and its management. Eur Spine J. 2001;10(5):370-384."},{"issue":"4","key":"bib8","series-title":"J Bone Miner Res","first-page":"579","article-title":"Diagnosis and management of Paget\u2019s disease of bone in adults: a clinical guideline","volume":"34","author":"Ralston","year":"2019","unstructured":"Ralston SHCorral-Gudino LCooper C, et al. Diagnosis and management of Paget\u2019s disease of bone in adults: a clinical guideline. J Bone Miner Res. 2019;34(4):579-604."},{"issue":"1","key":"bib9","series-title":"Eur J Orthop Surg Traumatol","first-page":"27","article-title":"Surgical treatment in spine Paget\u2019s disease: a systematic review","volume":"26","author":"Jorge-Mora","year":"2016","unstructured":"Jorge-Mora AAmhaz-Escanlar SLois-Iglesias ALeborans-Eiris SPino-Minguez J. Surgical treatment in spine Paget\u2019s disease: a systematic review. Eur J Orthop Surg Traumatol. 2016;26(1):27-30."},{"issue":"10","key":"bib10","series-title":"J Orthop Case Rep","first-page":"1","article-title":"A polyostotic Paget\u2019s disease involving lumbar spine presenting with cauda equina syndrome: an unusual entity","volume":"11","author":"Hadgaonkar","year":"2021","unstructured":"Hadgaonkar SPatwardhan SBhilare PSancheti PShyam A. A polyostotic Paget\u2019s disease involving lumbar spine presenting with cauda equina syndrome: an unusual entity. J Orthop Case Rep. 2021;11(10):1-5."},{"issue":"12","key":"bib11","series-title":"Eur Spine J","first-page":"3066","article-title":"Paget\u2019s disease of the lumbar spine: decompressive surgery following 17 years of bisphosphonate treatment","volume":"27","author":"Hofmann","year":"2018","unstructured":"Hofmann AOpitz SHeyde CEvon der H\u00f6h NH. Paget\u2019s disease of the lumbar spine: decompressive surgery following 17 years of bisphosphonate treatment. Eur Spine J. 2018;27(12):3066-3070."},{"issue":"suppl","key":"bib12","series-title":"J Bone Miner Res","first-page":"34","article-title":"Surgical management of Paget\u2019s disease","volume":"14","author":"Kaplan","year":"1999","unstructured":"Kaplan FS. Surgical management of Paget\u2019s disease. J Bone Miner Res. 1999;14(suppl 2):34-38."},{"issue":"8","key":"bib13","series-title":"Clin Case Rep","first-page":"e6263","article-title":"Spinal Paget\u2019s disease with bilevel cord compression and ischemic non-compressive myelopathy treated with zoledronic acid","volume":"10","author":"Feki","year":"2022","unstructured":"Feki ASellami IGassara Z, et al. Spinal Paget\u2019s disease with bilevel cord compression and ischemic non-compressive myelopathy treated with zoledronic acid. Clin Case Rep. 2022;10(8):e6263."},{"issue":"3","key":"bib14","series-title":"Eur Spine J","first-page":"453","article-title":"Skeletal dissemination in Paget\u2019s disease of the spine","volume":"27","author":"Rolvien","year":"2018","unstructured":"Rolvien TButscheidt SZustin JAmling M. Skeletal dissemination in Paget\u2019s disease of the spine. Eur Spine J. 2018;27(3)(suppl 3):453-457."},{"issue":"2","key":"bib15","series-title":"Can J Surg","first-page":"140","article-title":"Strut allograft invasion by Paget\u2019s disease of bone: a case report","volume":"43","author":"Cameron","year":"2000","unstructured":"Cameron HUFornasier VLVan Zyl DV. Strut allograft invasion by Paget\u2019s disease of bone: a case report. Can J Surg. 2000;43(2):140-141."},{"issue":"1","key":"bib16","series-title":"Z Orthop Ihre Grenzgeb","first-page":"47","article-title":"Das Fortschreiten eines M. Paget in der Wirbels\u00e4ule 10 Jahre nach einer posterolateralen Spondylodese.","volume":"127","author":"Hopf","year":"1989","unstructured":"Hopf CHahn K. Das Fortschreiten eines M. Paget in der Wirbels\u00e4ule 10 Jahre nach einer posterolateralen Spondylodese.Z Orthop Ihre Grenzgeb. 1989;127(1):47-50."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/8\/4\/article-CASE24203.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/8\/4\/article-CASE24203.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/8\/4\/article-CASE24203.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:53:13Z","timestamp":1769687593000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/8\/4\/article-CASE24203.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,22]]},"references-count":32,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/case24203","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,22]]}}}