Facet-Destructive Cervical Tumoral Calcinosis Causing Myelopathy in Systemic Sclerosis: A Case Report and Literature Review.

Tumoral calcinosis (TC) is a rare disorder characterized by periarticular ectopic calcium deposition, with spinal involvement being exceptionally uncommon. We report a rare case of facet-destructive cervical TC causing progressive cervical myelopathy in a patient with diffuse systemic sclerosis and review the current literature on its pathogenesis, diagnosis, and management. A 51-year-old woman with diffuse systemic sclerosis presented with progressive neck pain, worsening cervical kyphosis, and cervical myelopathy. Computed tomography and magnetic resonance imaging demonstrated multilobulated calcific masses involving the posterior elements and facet joints from C3 to C6, resulting in severe cervical canal stenosis. She underwent C3-6 decompressive laminectomy with posterior instrumented fusion. Intraoperatively, the lesions had extensively replaced the bilateral lateral masses and posterior elements from C3 to C5 and were densely adherent to the dura, precluding complete excision. Adequate decompression was achieved through careful internal debulking and lateral release of the calcified masses, with intraoperative ultrasonography confirming satisfactory decompression. Postoperatively, her neck pain resolved and neurological function improved progressively; independent ambulation was regained by six months. Although rare, spinal TC should be considered in the differential diagnosis of calcified spinal lesions, particularly in patients with connective tissue disease. Surgical decompression with stabilization remains the treatment of choice for patients presenting with neurological compromise.