Skip to main content
Erschienen in: European Spine Journal 3/2018

17.01.2018 | Case Report

Skeletal dissemination in Paget’s disease of the spine

verfasst von: Tim Rolvien, Sebastian Butscheidt, Jozef Zustin, Michael Amling

Erschienen in: European Spine Journal | Sonderheft 3/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Paget’s disease of bone (PDB) is a common skeletal disorder that is associated with locally increased bone turnover, skeletal deformity and pain. We report a case of skeletal dissemination in PDB of the spine.

Methods

Case report.

Results

A 46-year-old former professional athlete suffered from disseminated PDB throughout the spine and hips after various surgical interventions including spondylodesis, bone grafting and bone morphogenetic protein (rhBMP-2) administration. Only intravenous zoledronic acid prevented the further progression of skeletal dissemination, which was expressed by a normalization of (bone-specific) alkaline phosphatase levels. The biopsy obtained from the lumbar spine confirmed the diagnosis of PDB in the absence of malignant transformation.

Conclusions

We outline skeletal dissemination as a possibly surgery-related complication in a patient with PDB in the lumbar spine. Bisphosphonates remain the treatment of first choice in PDB and surgical interventions should be considered very carefully.
Literatur
1.
Zurück zum Zitat Paget J (1877) On a form of chronic inflammation of bones (osteitis deformans). Med Chir Trans 60(37–64):39 Paget J (1877) On a form of chronic inflammation of bones (osteitis deformans). Med Chir Trans 60(37–64):39
3.
Zurück zum Zitat Zimmermann EA, Kohne T, Bale HA, Panganiban B, Gludovatz B, Zustin J, Hahn M, Amling M, Ritchie RO, Busse B (2015) Modifications to nano- and microstructural quality and the effects on mechanical integrity in Paget’s disease of bone. J Bone Miner Res 30(2):264–273. https://doi.org/10.1002/jbmr.2340 CrossRefPubMed Zimmermann EA, Kohne T, Bale HA, Panganiban B, Gludovatz B, Zustin J, Hahn M, Amling M, Ritchie RO, Busse B (2015) Modifications to nano- and microstructural quality and the effects on mechanical integrity in Paget’s disease of bone. J Bone Miner Res 30(2):264–273. https://​doi.​org/​10.​1002/​jbmr.​2340 CrossRefPubMed
4.
Zurück zum Zitat Albagha OM, Visconti MR, Alonso N, Wani S, Goodman K, Fraser WD, Gennari L, Merlotti D, Gianfrancesco F, Esposito T, Rendina D, di Stefano M, Isaia G, Brandi ML, Giusti F, Del Pino-Montes J, Corral-Gudino L, Gonzalez-Sarmiento R, Ward L, Rea SL, Ratajczak T, Walsh JP, Ralston SH (2013) Common susceptibility alleles and SQSTM1 mutations predict disease extent and severity in a multinational study of patients with Paget’s disease. J Bone Miner Res 28(11):2338–2346. https://doi.org/10.1002/jbmr.1975 CrossRefPubMed Albagha OM, Visconti MR, Alonso N, Wani S, Goodman K, Fraser WD, Gennari L, Merlotti D, Gianfrancesco F, Esposito T, Rendina D, di Stefano M, Isaia G, Brandi ML, Giusti F, Del Pino-Montes J, Corral-Gudino L, Gonzalez-Sarmiento R, Ward L, Rea SL, Ratajczak T, Walsh JP, Ralston SH (2013) Common susceptibility alleles and SQSTM1 mutations predict disease extent and severity in a multinational study of patients with Paget’s disease. J Bone Miner Res 28(11):2338–2346. https://​doi.​org/​10.​1002/​jbmr.​1975 CrossRefPubMed
13.
17.
Zurück zum Zitat Yasko AW, Lane JM, Fellinger EJ, Rosen V, Wozney JM, Wang EA (1992) The healing of segmental bone defects, induced by recombinant human bone morphogenetic protein (rhBMP-2). A radiographic, histological, and biomechanical study in rats. J Bone Joint Surg Am 74(5):659–670CrossRefPubMed Yasko AW, Lane JM, Fellinger EJ, Rosen V, Wozney JM, Wang EA (1992) The healing of segmental bone defects, induced by recombinant human bone morphogenetic protein (rhBMP-2). A radiographic, histological, and biomechanical study in rats. J Bone Joint Surg Am 74(5):659–670CrossRefPubMed
19.
Zurück zum Zitat Cameron HU, Fornasier VL, Van Zyl DV (2000) Strut allograft invasion by Paget’s disease of bone: a case report. Can J Surg 43(2):140–141PubMedPubMedCentral Cameron HU, Fornasier VL, Van Zyl DV (2000) Strut allograft invasion by Paget’s disease of bone: a case report. Can J Surg 43(2):140–141PubMedPubMedCentral
20.
Zurück zum Zitat Dunford JE, Thompson K, Coxon FP, Luckman SP, Hahn FM, Poulter CD, Ebetino FH, Rogers MJ (2001) Structure-activity relationships for inhibition of farnesyl diphosphate synthase in vitro and inhibition of bone resorption in vivo by nitrogen-containing bisphosphonates. J Pharmacol Exp Ther 296(2):235–242PubMed Dunford JE, Thompson K, Coxon FP, Luckman SP, Hahn FM, Poulter CD, Ebetino FH, Rogers MJ (2001) Structure-activity relationships for inhibition of farnesyl diphosphate synthase in vitro and inhibition of bone resorption in vivo by nitrogen-containing bisphosphonates. J Pharmacol Exp Ther 296(2):235–242PubMed
Metadaten
Titel
Skeletal dissemination in Paget’s disease of the spine
verfasst von
Tim Rolvien
Sebastian Butscheidt
Jozef Zustin
Michael Amling
Publikationsdatum
17.01.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe Sonderheft 3/2018
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-018-5477-4

Weitere Artikel der Sonderheft 3/2018

European Spine Journal 3/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.