Analysis of the efficacy of UBE in the treatment of tophus deposition within the lumbar spinal canal.

RATIONALE: Lumbar intraspinal gouty tophus deposition is clinically rare, with nonspecific clinical/imaging features leading to frequent misdiagnosis. Current treatments mainly rely on open surgery, and systematic reports on Unilateral Biportal Endoscopy (UBE) application are scarce, necessitating exploration of UBE's efficacy. PATIENT CONCERNS: Seven patients (October 2023-November 2024) presented with persistent low back pain, accompanied by lower limb pain and/or numbness. Conservative treatment (urate-lowering drugs, anti-inflammatory drugs, and physical therapy) for ≥3 months was ineffective, and symptoms persisted or worsened. DIAGNOSES: Postoperative pathological examination confirmed urate crystal deposition (gold standard for gouty tophi). Preoperative computed tomography showed spinal canal soft tissue calcification, and magnetic resonance imaging revealed lumbar facet joint amorphous substance deposition, with obvious lumbar spinal stenosis and nerve root compression. INTERVENTIONS: All patients underwent UBE surgery-removing tophi, decompressing spinal/nerve root canals, placing drainage tubes, and receiving postoperative urate-lowering, anti-inflammatory, and nerve-nourishing treatments. OUTCOMES: All surgeries succeeded; VAS (8.00 ± 0.82→1.57 ± 0.54) and ODI (66.14 ± 3.93→18.29 ± 2.69) improved significantly (P < .05). No complications occurred; 3-12 months follow-up showed no tophus recurrence, and patients resumed daily activities. LESSONS: UBE has good short-term efficacy for this disease, offering a minimally invasive option, but long-term efficacy requires further observation to supplement spinal gout treatment evidence.