Soehle Martin, Casey Adrian T H
Department of Surgical Neurology, The National Hospital for Neurology and Neurosurgery, London, England.
Neurosurgery. 2002 Jul;51(1):239-42; discussion 242-3. doi: 10.1097/00006123-200207000-00038.
X-linked hypophosphatemic rickets is a common inherited phosphate-wasting disorder, but it is a rare cause of spinal cord compression. We present the first reported case of a calcified intervertebral disc causing spinal canal stenosis in X-linked hypophosphatemic rickets.
A 44-year-old woman presented with paresthesia of her left arm and a loss of grip in both hands. Magnetic resonance imaging revealed a calcified intervertebral disc, as well as a posterior osteophytic bar causing marked cervical cord compression at C6/C7.
An anterior cervical discectomy at C6/C7 and fusion with autologous bone graft were performed. The patient then exhibited significant improvement.
A review of the 16 published cases demonstrates that thickening of the vertebral laminae, facet joint hypertrophy, and ossification of the intervertebral discs, posterior longitudinal ligament, and/or ligamentum flavum contribute to spinal canal stenosis in X-linked hypophosphatemic rickets. Those changes are caused by the disease itself and are unlikely to be related to long-term vitamin D treatment. Eleven of 16 patients were reported to have experienced favorable outcomes after surgery.
X连锁低磷性佝偻病是一种常见的遗传性磷酸盐消耗性疾病，但它是脊髓压迫症的罕见病因。我们报告首例X连锁低磷性佝偻病中钙化椎间盘导致椎管狭窄的病例。
一名44岁女性出现左臂感觉异常和双手握力丧失。磁共振成像显示一个钙化椎间盘，以及一个后骨赘条带，在C6/C7水平导致明显的颈髓压迫。
在C6/C7水平行前路颈椎间盘切除及自体骨移植融合术。患者随后有显著改善。
对16例已发表病例的回顾表明，椎板增厚、小关节肥大以及椎间盘、后纵韧带和/或黄韧带骨化导致X连锁低磷性佝偻病中的椎管狭窄。这些改变由疾病本身引起，不太可能与长期维生素D治疗有关。16例患者中有11例术后预后良好。
