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Vertebral Compromised in Paget´S Disease

Abstract
Paget's bone disease (PD) is characterized by a focal disorder of the skeleton, initially determined by an excessive bone resorption and subsequent exaggerated formation, finally adopting a typical histological configuration often referred to as "mosaic-like". Macroscopically, the bone is deformed and its diameters are enlarged, resulting in a greater bone size, which is very vascularized and with a disordered structure. This abnormality seems to lie in the regulation of osteoclasts, which are increased in number and size. The most common location is the axial skeleton, especially the pelvis, sacrum, lumbar spine and skull. In our sample of patients with PD, we found vertebral compromise in 47% of patients who had previously been classified as monostotic and in 36.8% of polyostotic PD patients. Vertebral compromise can affect the spinal cord because of complications in the circulation, generating a quadriparesis or paraparesis, depending on the affected vertebral level. The hypothesis suggested by this condition is vascular "theft" or "entrapment". We subscribe to the importance of early medication of these patients with vertebral complications, because these neurological problems can be dramatically turned round using the now simple and appropriate medical treatment of PD.

Key words
Paget's disease, vertebral compromise

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