title: Acute lumbar spinal pseudogout attack after instrumented surgery.
abstract: METHODS
  A case report.
  
  
  OBJECTIVE
  An elderly patient presented with an acute lumbar spinal pseudogout attack after lumbar instrumented surgery.
  
  
  BACKGROUND
  Although gout and pseudogout are common diseases causing inflammatory arthropathy in peripheral joints, involvement of the spine is uncommon. Here, we report a patient experiencing an acute lumbar spinal pseudogout attack after lumbar instrumented surgery.
  
  
  METHODS
  The patient was treated for lumbar spondylolisthesis at L4 and L5 level and afterward complained of lower back and bilateral leg pain. Conservative treatment was not effective for the patient; therefore, we preformed posterior transforaminal lumbar interbody fusion surgery.
  
  
  RESULTS
  The postoperative course was uneventful; however, he experienced lower back pain 4 weeks after surgery. Magnetic resonance image showed changes in signal intensities of vertebra and fluid accumulation in posterior back muscles. A biopsy was performed, but the culture was negative for infection. Calcium pyrophosphate dehydrate was detected in the fluid. Thus, conservative therapy without antibiotics was performed, and the patient's symptoms disappeared within 2 weeks.
  
  
  CONCLUSIONS
  Here, we reported the first case of acute lumbar spinal pseudogout attack after lumbar instrumented surgery. We recommend considering pseudogout before and after surgery.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nagatsuma
authors.forename: Gou
authors.initials: G
authors.lastname: Kubota
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.forename: Yawara
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Ochiai
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kuniyoshi
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Aoki
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyagi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kamoda
authors.forename: Miyako
authors.initials: M
authors.lastname: Suzuki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Inage
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sainoh
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakamura
authors.forename: Shunji
authors.initials: S
authors.lastname: Kishida
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
mesh_terms: D000368:Aged; D002805:Chondrocalcinosis / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011859:Radiography; D012585:Sciatica / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome