Ochiai Hidenobu, Yamakawa Yuzo, Minato Seiichiro, Nakahara Keiichi, Nakano Shinichi, Wakisaka Shinichiro
Department of Neurosurgery, Miyazaki Medical College, 5200, Kihara, Kiyotake, Miyazaki 889-1692, Japan.
J Neurol. 2002 May;249(5):549-53. doi: 10.1007/s004150200063.
Cervical compressive myelopathy patients sometimes show localized girdle sensation in the mid trunk (so-called false localizing sign). This symptom often confuses physicians, but the clinical features and mechanism of this symptom are still unclear. We investigated the clinical features and possible mechanism. In each of five cases of cervical compressive myelopathy disease with and without mid-truncal girdle sensation, the clinical features, degree and shape of cord compression were analysed. The girdle sensation was expressed as a vague or burning sensation, and was localized with a width of 3 or 4 dermatomes from the T3 to T11 level. There was no correlation between the appearance of the girdle sensation and etiology and level of cervical cord compression. Pyramidal tract signs and disturbance of superficial sensation were observed in all cases. Furthermore, on axial MRI, the midline ventral surface of the cervical cord was remarkably compressed in cases with girdle sensation, as if the compressive lesion entered the anterior medial fissure of the cervical cord. From these findings, this false localizing sign may be caused by severe compression of midline ventral structure of the cervical cord. Ischemia of the thoracic watershed zone of the anterior spinal artery from the compression of the anterior spinal artery at the cervical level might also be considered to be a possible cause.
脊髓型颈椎病患者有时会在躯干中部出现局部束带感（所谓的假性定位体征）。这种症状常常使医生感到困惑，但其临床特征和机制仍不清楚。我们对其临床特征及可能的机制进行了研究。在5例有或无躯干中部束带感的脊髓型颈椎病患者中，分析了其临床特征、脊髓受压的程度和形态。束带感表现为模糊或烧灼感，定位在T3至T11水平，宽度为3或4个皮节。束带感的出现与病因及颈髓受压水平之间无相关性。所有病例均观察到锥体束征和浅感觉障碍。此外，在轴向MRI上，有束带感的病例中颈髓中线腹侧表面明显受压，就好像压迫性病变进入了颈髓的前内侧沟。从这些发现来看，这种假性定位体征可能是由颈髓中线腹侧结构的严重受压所致。颈段脊髓前动脉受压导致胸段脊髓前动脉分水岭区缺血也可能是一个原因。
