Erschienen in:
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.
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.