Rudnick Jonathan, Stern Michelle
College of Physicians and Surgeons-Columbia University and New York-Presbyterian Hospital, New York, NY, USA.
Arch Phys Med Rehabil. 2004 Sep;85(9):1544-7. doi: 10.1016/j.apmr.2003.08.099.
Vertebral hemangiomas are relatively common, but those causing spinal cord compression are rare. A man in his early sixties with back pain that had not resolved with conservative treatment was seen in an outpatient physiatrist office. Subsequent workup with computed tomography scan showed a large hemangioma in the T5 vertebra extending to the posterior elements where his pain was located. Three weeks later, the patient had progressive weakness and numbness in his lower extremity. He subsequently underwent a T3-5 laminectomy, with a subtotal resection of the mass. He reported improvement in lower-extremity strength and sensation and completed a course of inpatient rehabilitation. Recognizing when to expect neurologic symptoms and the proper time to intervene can be very critical. From this case study and other similar instances, one can conclude that vertebral hemangiomas are not always benign and are capable of causing cord compression. Proper diagnosis and treatment may prevent the development of neurologic symptoms.
椎体血管瘤相对常见，但导致脊髓受压的情况罕见。一名60岁出头的男性因背痛接受保守治疗后未缓解，在门诊物理治疗师办公室就诊。随后的计算机断层扫描显示，T5椎体有一个大血管瘤，延伸至他疼痛部位的后部结构。三周后，患者下肢逐渐出现无力和麻木。随后他接受了T3 - 5椎板切除术，并对肿块进行了次全切除。他报告下肢力量和感觉有所改善，并完成了一个疗程的住院康复治疗。认识到何时会出现神经症状以及何时进行适当干预至关重要。从这个病例研究和其他类似案例可以得出结论，椎体血管瘤并非总是良性的，能够导致脊髓受压。正确的诊断和治疗可以预防神经症状的发展。
