Spinal-cord compression in paget's disease

Abstract

The literature on the subject of spinal‐cord compression in Paget's disease including its association with a paravertebral mass is reviewed. This mass is thought to be a pseudocallus and is an attempt on the part of the diseased bone to stabilize its structure and is seen at sites in the vertebral column where the disease process is most active. The symptoms including girdle pains are relieved by laminectomy. A decompressive laminectomy is indicated in the treatment of these patients and produces good results.

Spinal cord compression in Paget's disease

“…Two of our cases, in common with a number of those previously described, had histories and other features strongly suggestive of extradural metastasis (Siegelman et al, 1968;Direkze and Milnes, 1970). While the latter are often subjected to decompression, radiotherapy is a common alternative treatment without histological conformation of the diagnosis (Millburn, Hibbs, and Hendrickson, 1968) and the importance of recognizing these odd cases of Paget's disease is therefore stressed.…”

“…While the latter are often subjected to decompression, radiotherapy is a common alternative treatment without histological conformation of the diagnosis (Millburn, Hibbs, and Hendrickson, 1968) and the importance of recognizing these odd cases of Paget's disease is therefore stressed. The radiological demonstration of a paraspinal mass with neural arch involvement is undoubtedly the most vital clue to the diagnosis (Latimer et al, 1953;Direkze and Milnes, 1970).…”

“…Among such lesions, Paget's disease of bone is well recognized and, although rare, it has several characteristic features (Wyllie, 1923;Hartman and Dohn, 1966;Miller, 1967;Siegelman, Levine, and Walpin, 1968;Feldman and Seaman, 1969;Direkze and Milnes, 1970). Furthermore, as results of decompression may be very good (Latimer, Webster, and Gurdjian, 1953), its diagnosis is vital (Siegelman et al, 1968).…”

“…In most recorded cases the history of paraparesis has been of about one year's duration (Aldren Turner, 1940;Latimer et al, 1953) and approximately 5000 of cases have had local and girdle pain over a similar period. The radiological appearance of the vertebral bodies may not always be diagnostic but when a partly calcified paravertebral mass is demonstrated, or when there is involvement of the neural arch, the nature of the lesion is in little doubt (Latimer et al, 1953;Direkze and Milnes, 1970).…”

Ossification in extradural fat in Paget's disease of the spine

“…As far as we are aware, ossification in extradural fat in this condition has not previously been reported. Subperiosteal bone spicuiation is, on the other hand, well recognized (Direzke and Milnes, 1970). According to Klenerman (1966) the dura mater is densely adherent to the adjacent bone in Paget's disease of the spine, but this was not our experience in the present case.…”