Dahlström U, Järpe S, Lindström F D
Acta Med Scand. 1979;205(3):173-8. doi: 10.1111/j.0954-6820.1979.tb06026.x.
A retrospective study of 20 cases of multiple myelomatosis and paraparesis treated during 1966-77 is presented. All patients but one had been submitted to decompressive laminectomy. A close correlation between duration of paraparesis before operation and prognosis was found, eight patients with a duration of paraparesis of several days remaining paraplegic. No particular paraparesisprone patient group with respect to duration of myelomatous disease, Ig class or various laboratory findings could be identified. In several instances radionuclide scan was effective in localizing vertebral lesion. In most patients radicular type back pain signalled vertebral damage and subsequent paraparesis. In many cases long survival after operation and excellent to good functional results made surgery a worthwhile procedure. The importance of postoperative radiotherapy and adequate chemotherapy is stressed.
本文对1966年至1977年间治疗的20例多发性骨髓瘤合并轻截瘫患者进行了回顾性研究。除1例患者外，所有患者均接受了减压性椎板切除术。发现术前轻截瘫持续时间与预后密切相关，8例轻截瘫持续数天的患者仍为截瘫。在骨髓瘤病程、免疫球蛋白类别或各种实验室检查结果方面，未发现特别易患轻截瘫的患者群体。在一些病例中，放射性核素扫描可有效定位椎体病变。在大多数患者中，神经根型背痛提示椎体损伤及随后的轻截瘫。在许多病例中，术后长期存活及良好至优秀的功能结果使手术成为一项值得进行的操作。强调了术后放疗和充分化疗的重要性。
