Paraparesis Secondary to Sodium Urate Deposits in the Ligamentum Flavum

Compression of the spinal cord or roots by sodium urate deposits has been demonstrated previously only twice.1.2In three other autopsy cases, sodium urate was deposited in tissues surrounding the spinal cord and cauda equina, including vertebral bodies and disks,3intervertebral facets,4and odontoid, atlas, and dura.5 Report of a Case.— We examined a 74-year-old man who had gout and hyperuricemia since 1964 (serum levels have varied from 7.1 to 10.6 mg/dl). For the two years preceding hospital admission, allopurinol, 400 mg/day, and colchicine, 1.0 mg/ day, were prescribed, but probably not taken regularly. The patient noted severe, unrelenting pain radiating into both buttocks in February 1975. The pain was aggravated by sitting on a toilet seat, but not by Valsalva maneuvers. The pain gradually increased in intensity, and paresis of dorsi and plantar flexion of both feet developed in May 1975.