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[一名脊髓型颈椎病患者的分离性排尿障碍]

[Dissociated micturitional disturbance in a patient with cervical spondylotic myelopathy].

作者信息

Nishio Yoshiyuki, Takane Kohki, Hasegawa Takashi, Inoue Kiyoharu, Honda Kazuya

机构信息

Department of Neurology, Jikei University School of Medicine.

出版信息

Rinsho Shinkeigaku. 2005 Mar;45(3):226-9.

Abstract

A 58-year-old man developed dysuria and residual sensation one year after the traffic accident. Half a year later, he developed chest pain and underwent coronary arteriography. Numbness in the left arm, burning sensation below the knees and urinary retention emerged immediately after prolonged neck extention during the examination. He required intermittent catheterization of the bladder because of persistent dysuria. Urodynamic study revealed detrusor-sphincter dyssynergia. The micturitional disturbance improved with the application of a soft cervical collar and a bed rest. MRI of the cervical spine showed spinal cord compression at the C5/6 and a small hyperintensity area on T2WI in the spinal cord at the C5 level. The case suggests that micturitional dysfunction can be severe without remarkable sensorimotor disturbances of the lower extremities in cervical spondylotic myelopathy.

摘要

一名58岁男性在交通事故一年后出现排尿困难和残余感觉。半年后,他出现胸痛并接受了冠状动脉造影。在检查过程中,长时间伸展颈部后,他立即出现左臂麻木、膝盖以下烧灼感和尿潴留。由于持续性排尿困难,他需要间歇性膀胱导尿。尿动力学研究显示逼尿肌-括约肌协同失调。应用软颈托和卧床休息后,排尿障碍有所改善。颈椎MRI显示C5/6水平脊髓受压,C5水平脊髓T2WI上有一个小的高信号区。该病例提示,在颈椎病性脊髓病中,排尿功能障碍可能很严重,而下肢却没有明显的感觉运动障碍。

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