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European Spine Journal

, Volume 27, Supplement 3, pp 453–457 | Cite as

Skeletal dissemination in Paget’s disease of the spine

  • Tim Rolvien
  • Sebastian Butscheidt
  • Jozef Zustin
  • Michael Amling
Case Report

Abstract

Purpose

Paget’s disease of bone (PDB) is a common skeletal disorder that is associated with locally increased bone turnover, skeletal deformity and pain. We report a case of skeletal dissemination in PDB of the spine.

Methods

Case report.

Results

A 46-year-old former professional athlete suffered from disseminated PDB throughout the spine and hips after various surgical interventions including spondylodesis, bone grafting and bone morphogenetic protein (rhBMP-2) administration. Only intravenous zoledronic acid prevented the further progression of skeletal dissemination, which was expressed by a normalization of (bone-specific) alkaline phosphatase levels. The biopsy obtained from the lumbar spine confirmed the diagnosis of PDB in the absence of malignant transformation.

Conclusions

We outline skeletal dissemination as a possibly surgery-related complication in a patient with PDB in the lumbar spine. Bisphosphonates remain the treatment of first choice in PDB and surgical interventions should be considered very carefully.

Keywords

Paget’s disease of bone Dissemination Bisphosphonates Alkaline phosphatase Spondylodesis 

Notes

Compliance with ethical standards

Conflict of interest

None of the authors has any potential conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Osteology and BiomechanicsUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Orthopaedic SurgeryUniversity Medical Center Hamburg-EppendorfHamburgGermany
  3. 3.Pathologie HamburgHamburgGermany

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