• Zach Pennington, Jeremy L Fogelson, and William E Krauss.
• Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: zach.pennington.93@gmail.com.
• World Neurosurg. 2023 Dec 1; 180: 101210-12.

AbstractSystemic sclerosis affects 14-21 per million persons annually and can present with calcinosis-deposition in the skin and subcutaneous tissues. In rare circumstances, paraspinal depositions are also seen, which can cause neural element compression requiring surgical intervention. Here we present the case of a 61-year-old woman with systemic sclerosis on goal-directed therapy who presented with neurogenic pseudoclaudication and imaging suggesting severe joint hypertrophy. The case illustrates that calcinosis in scleroderma can cause facet joint pseudohypertrophy that is difficult to distinguish from true hypertrophy on imaging. Such pseudohypertrophy is often refractory to medical therapy, necessitating surgical intervention. Last, owing to the fluid nature of the calcinotic fluid, decompression is often easier than would be expected based on preoperative imaging alone.Copyright © 2023 Elsevier Inc. All rights reserved.

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