Tumoral Calcinosis of the Thoracolumbar Spine Associated With Adjacent Segment Degeneration After Lumber Fusion: A Case of Myelopathy.

Tumoral calcinosis is characterized by the deposition of calcified masses in peri-articular tissues, typically near joints. Spinal involvement is rare, particularly following adjacent segment degeneration (ASD) after lumbar spinal fusion. We present the case of a 73-year-old female who developed tumoral calcinosis with myelopathy following lumbar fusion surgery. She had previously undergone two lumbar spine surgeries, which resulted in lumbar fusion from L2 to L5. She developed lower back and leg pain, which progressively worsened, eventually leading to bilateral lower limb paralysis, paresthesia, bladder and rectal dysfunction, and gait disturbance. Computed tomography revealed calcified lesions at the T12-L1 segment adjacent to the spinal fusion. Surgical treatment included laminectomy with resection of the calcified lesions for decompression and extended fusion for stabilization. Complete removal of the calcified lesions via a posterior approach was challenging due to its extensive anterior involvement; therefore, partial resection was performed. A white calcified substance was extracted from the lesion, and ultrasound confirmed adequate decompression of the spinal cord. Postoperatively, the patient showed significant neurological improvement, and follow-up imaging showed no progression of the calcified lesion. This case highlights the importance of considering tumoral calcinosis in the differential diagnosis of spinal cord compression following ASD after spinal fusion. Spinal instability due to ASD may contribute to the development of spinal tumoral calcinosis, and surgical decompression and stabilization appear to be effective treatment options.