2011 Volume 60 Issue 2 Pages 273-277
The anterior chest wall is the most frequent location of musculoskeletal lesions caused by synovitis-acne-pustulosis- hyperosteosis-osteomyelitis (SAPHO) syndrome. Spinal lesions are present in about 30% of the cases, but kyphosis and neurological complications are unusual. We surgically treated a 42 year-old man with SAPHO syndrome who had myelopathy due to thoracolumbar kyphosis.
In another 31-year-old male case complaining of back pain, abnormal accumulation was observed at the thoracic vertebra, left side of sternum, left clavicle, and left rib in bone scintigram. In another 40-year-old male case, we diagnosed tonsillitis and removed the tonsil. Thoracic X-ray revealed wedge-shaped vertebral body at T12, and kyphosis progressed gradually. MRI showed the compression of the spinal cord at T11 and 12 levels. We performed a vertebral biopsy at T12, the pathologic findings of the specimen indicated nonspecific chronic inflammation, and the culture was negative. We diagnosed the lesion as spondylitis as a part of SAPHO syndrome. The 42-year-old found it difficult to keep standing because of his back pain and was unable to walk by himself due to myelopathy, so we performed anterior vertebral body curettage with anterior ilium transplantation, as well as posterior instrumentation at the same time. After surgery, his kyphosis was corrected, myelopathy improved, and he was able to walk. Two years postoperatively, his clinical course is good without correction loss.
