In chronic tophaceous gout, depositions of monosodium urate crystals commonly occur in bones, joints and periarticular tissues of the appendicular skeleton. Spinal manifestation of gout is uncommon. We have experienced an extremely rare case of tophaceous gout producing spinal cord compression with no peripheral tophi. The case promoted a review of the literature. Documented urate deposition in the spine is exceedingly rare. The clinical course and radiologic manifestations are discussed.