Introduction: Acute gout arthritis and tophaceous gout of the spine is rare.
Exegesis: We report the case of a 54-year-old man with chronic low back pain. Physical examination and myelography showing neurological compression on L4 laminectomy evidenced tophaceous gout.
Conclusion: Gout arthritis should always be suspected and investigated in patients with either chronic low back pain or non-specific spinal cord compression.