title: SAPHO syndrome with rapidly progressing destructive spondylitis: two cases treated surgically.
abstract: The authors present two cases of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome with rapidly progressing destructive spondylitis treated surgically. The spinal lesions in SAPHO syndrome generally have a good prognosis and rarely cause the structural destruction or neurological deterioration. Case 1: a 63-year-old female had palmoplantar pustulosis for 2 years. At first, she only felt a pain in the nape with no inducing factor. Two months later, she had incomplete quadriplegia (ASIA scale C). Magnetic resonance imaging showed destruction of C4-C7, kyphotic deformity, and severe compression of the spinal cord. Decompression and reconstruction surgery using anterior and posterior approach improved her paralysis. Case 2: a 69-year-old female complained of persistent back pain. Magnetic resonance imaging revealed spondylitis of T7-T9. Although there were no typical skin lesions, we diagnosed SAPHO syndrome by hyperostosis of the sternocostoclavicular joint and sacral joint. Destruction with kyphotic deformity of the spine progressed gradually for 3 months. Curettage and reconstruction surgery using thoracic endoscope relieved her pain and prevented the destruction of the spine. The histopathology of the specimen obtained surgically showed non-specific inflammation in both cases. Spondylitis in SAPHO syndrome may cause severe destruction and kyphotic deformity followed by paralysis.
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama City, Okayama, 700-8558, Japan. takigawa2004@yahoo.co.jp
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takigawa
authors.forename: Masato
authors.initials: M
authors.lastname: Tanaka
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Nakahara
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Sugimoto
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
mesh_terms: D020083:Acquired Hyperostosis Syndrome / Q000150:complications*; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D018450:Disease Progression; D004724:Endoscopy; D005260:Female; D006801:Humans; D015576:Hyperostosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D007738:Kyphosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D013117:Spinal Cord Compression / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D013166:Spondylitis / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D013247:Sternoclavicular Joint / Q000473:pathology / Q000503:physiopathology; D013904:Thoracic Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome