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10. Lumbar Spinal Involvement in Calcium Pyrophosphate Dihydrate Disease: A Systematic Literature Review

Author

Ben Tekaya A, Nacef L, Bellil M, Saidane O, Rouached L, Bouden S, Tekaya R, Mahmoud I, and Abdelmoula L

Subjects
chondrocalcinosis, calcium pyrophosphate dihydrate disease, spine, radiculopathy, sciatica, Medicine (General), R5-920
Abstract

Aicha Ben Tekaya,1,2 Lilia Nacef,1,2 Mehdi Bellil,2,3 Olfa Saidane,1,2 Leila Rouached,1,2 Selma Bouden,1,2 Rawdha Tekaya,1,2 Ines Mahmoud,1,2 Leila Abdelmoula1,2 1Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia; 2Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia; 3Orthopedic Department, Charles Nicolle Hospital, Tunis, TunisiaCorrespondence: Aicha Ben Tekaya, Rheumatology Department, Charles Nicolle Hospital, Tunis, Tunisia, Tel +216 97850485, Email aicha.bentekaya@fmt.utm.tnBackground: Calcium-pyrophosphate-dihydrate-disease (CPPD) is a crystal-induced arthropathy. The lumbar-spinal involvement is rare and often under-diagnosed. This study aimed to report the case of a lumbar spine CPPD involvement and to perform a systematic review of clinical, imaging features of lumbar involvement in CPPD patients, and treatments that have been implemented.Methods: This systematic review was conducted in accordance with the Preferred-Reporting-Items-for-Systematic-Reviews and Meta-Analyses (PRISMA) guidelines.Results: One hundred and sixty-seven articles met the search criteria using electronic databases searches. We retained 28 articles (20 case reports, 2 case series, 1 family survey, 4 retrospective studies, and 1 prospective study) involving a total of 62 patients. The age ranged between 39 and 89 years old. Among patients with lumbar spine CPPD, 32 were women. The duration of symptoms varied between one day and 8 years. The affection has been discovered during back pain in most cases. In 5 studies, the diagnosis was made on histological specimens of patients operated on for another pathology. X-ray showed calcifications in 2 cases. CT-scan detected calcium deposit in 7 cases. MRI showed lesions going from the increased signal of the disk, to calcified or not-cystic lesion of the facet joints, an intramedullary mass mimicking a schwannoma. Histological examination established the diagnosis of CPPD in 21 patients in all studies. Medical treatment included NSAIDs, Colchicine, Interleukin-1-receptor-antagonist, and antibiotics. Surgery was performed on 13 patients and allowed to establish the histological diagnosis.Conclusion: In the case of inflammatory back pain in elderly subjects, without an infectious gateway, diagnosis of CPPD should be considered, especially for patients with a history of spinal surgery or degenerative radiography changes. CT scan is more sensitive than conventional radiographs. The discovertebral biopsy is the Gold-Standard and should be performed whenever the diagnosis was uncertain. Treatment includes the medical and surgical components.Keywords: chondrocalcinosis, calcium pyrophosphate dihydrate disease, spine, radiculopathy, sciatica

Published
2022

40. AB1062 RENAL INVOLVEMENT IN SPONDYLOARTHRITIS

Author

Bouden, S., primary, Ben Messaoud, M., additional, Saidane, O., additional, Rouached, L., additional, Ben Tekaya, A., additional, Mahmoud, I., additional, Tekaya, R., additional, and Abdelmoula, L., additional

Published
2023
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43. Spondylodiscite tuberculeuse : 12 ans d'expérience dans un centre hospitalier en Tunisie

Author

Abdelmoula L, Ben Tekaya A, Cheikhrouhou S, Saidane O, Mahmoud I, and Tekaya R

Subjects
spondylite, discite, tuberculose vertébrale, Medicine, Microbiology, QR1-502
Abstract

Objectifs : Décrire les particularités épidémiologiques, cliniques et paracliniques des spondylodiscites tuberculeuses et déterminer les facteurs prédictifs d’une évolution défavorable. Patients et Méthode: Etude rétrospective sur une période de 12 ans. Le diagnostic a été porté sur des preuves bactériologiques, anatomopathologiques ou sur un faisceau d’arguments. Résultats : Il s’agissait de 49 patients (26F/23H), âgés en moyenne de 51,84 ans. Le délai moyen de diagnostic était de 6,65 mois. Un facteur prédisposant à l’infection a été relevé chez 38,7% des patients. L’étage lombaire était le plus touché (67,3%). L’imagerie par résonnance magnétique était pathologique dans tous les cas où elle a été effectuée. Le diagnostic de certitude a été porté dans 9 cas sur une preuve histologique. La ponction biopsie disco-vertébrale a permis de confirmer le diagnostic dans 6/36 cas. Tous les patients ont reçu un traitement anti-tuberculeux d’une durée moyenne de 13,59 mois associé à un geste interventionnel dans 8 cas. L’évolution était favorable dans 84,2% des cas. Nous avons identifiés quatre facteurs prédictifs d’une évolution défavorable: une hyperleucocytose initiale ≥11500 éléments/mm3 (p=0,031), la présence d’abcès ou de collection à l’imagerie (p=0,018); un tassement vertébral à l’IRM (p=0,018) et l’existence de déformation osseuse avant correction chirurgicale (p

Published
2017

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