{"id":"741a363c-6937-4353-b652-f41e84da0a46","slug":"gorham-stout-disease-a-multirod-lumbar-reconstruction-with-off-label-suppression-remission-therapy","title":"Gorham-Stout disease: A multirod lumbar reconstruction with off-label suppression-remission therapy","authors":["Ajay Krishnan","Aditya Raj","Devanand Degulmadi","Shivanand Mayi","Raviranjan Rai","Shiv Kumar Bali","Vatsal Parmar","Prarthan Chirag Amin","Preety Krishnan","Mirant Dave","Bharat Dave"],"abstract":"Background: Gorham-Stout disease (GSD), a fibro-lymphovascular entity in which tissue replaces the bone leading to massive osteolysis and its sequelae, rarely leads to spinal deformity/instability and neurological deficits. Here, we report a 12-year-old female who was diagnosed and treated for GSD. Case Description: A 12-year-old female presented with back pain, and the inability to walk, sit, or stand attributed to three MR/CT documented L2-L4 lumbar vertebral collapses. Closed biopsies were negative. However, an open biopsy diagnosed GSD. She underwent a dorsal-lumbar-to-pelvis fusion (i.e., T5-T12 through L5/S1/S2) using multilevel pedicle screw/rod stabilization and human leukocyte antigens (HLAs) matched allograft (i.e. from her father). Postoperatively, she was treated with “off-label” teriparatide injections, bisphosphonates, and sirolimus. Four years later, while continuing the bisphosphonate therapy, she remained stable. Conclusion: Surgical multirod stabilization from T5 to S2, supplemented with HLA compatible allograft, and multiple medical “off-label” therapies (i.e., teriparatide, sirolimus, and bisphosphonates) led to a good 4-year outcome in a 12-year-old female with GSD.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/741a363c-6937-4353-b652-f41e84da0a46/featured/hero-cropped-1781561492283.jpg","publishDate":"2022-04-08T00:00:00.000Z","doi":"10.25259/SNI_221_2022","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/741a363c-6937-4353-b652-f41e84da0a46/pdf"}