Sato M, Yamane K, Ezima M, Sugishita Y, Nozaki H
Department of Neurology, Ota-Atami Hospital.
Rinsho Shinkeigaku. 1991 Jul;31(7):717-9.
A 54-year-old man received insertion of an acupuncture needle into the region extending from the posterior neck to the back on two occasions for the treatment of shoulder stiffness. Two weeks after the second acupuncture, he developed fever, dysarthria and mictionary disturbance, finally reaching the condition of tetraplegia. He was immediately admitted to an emergency room in our hospital, and was diagnosed as sepsis with DIC, ARDS, heart failure, renal failure, liver failure, and myelitis. After one month, he recovered with transverse myelopathy as a residual deficit. Neurological findings showed transverse myelopathy below the level of Th2 at that time. Cervical CT revealed an irregular low density at the periphery of the cervical vertebra from the C2 to C4 level. Cervical MRI revealed an irregular swelling of his spinal cord from the C2 to C7 level. We explained the mechanism of transverse myelopathy in this case as follows. After the acupuncture, he suffered a focal infection of the region of needle insertion, and then the infection expanded to the cervical vertebra, thus causing osteomyelitis, sepsis, and finally cervical myelitis. Direct injury of the spinal cord and nerve roots as a complication of acupuncture was previously reported, but indirect injury of the spinal cord due to myelitis had not been reported except our present case. Careful attentions should be paid to the complications of acupuncture.
一名54岁男性因肩部僵硬，先后两次接受将针灸针插入从后颈部至背部区域的治疗。第二次针灸两周后，他出现发热、构音障碍和排尿障碍，最终发展为四肢瘫痪。他立即被送入我院急诊室，被诊断为脓毒症伴弥散性血管内凝血（DIC）、急性呼吸窘迫综合征（ARDS）、心力衰竭、肾衰竭、肝衰竭和脊髓炎。一个月后，他康复，但遗留横贯性脊髓病这一后遗症。当时的神经学检查结果显示胸2水平以下存在横贯性脊髓病。颈椎CT显示从C2至C4水平颈椎周边有不规则低密度影。颈椎MRI显示从C2至C7水平脊髓有不规则肿胀。我们对该病例中横贯性脊髓病的发病机制解释如下。针灸后，他在针刺部位发生局部感染，随后感染蔓延至颈椎，进而导致骨髓炎、脓毒症，最终引发颈段脊髓炎。先前曾报道过针灸作为并发症导致脊髓和神经根的直接损伤，但除了我们目前的病例外，尚未见因脊髓炎导致脊髓间接损伤的报道。应密切关注针灸的并发症。
