Nitta E, Ishiguro H, Baba H, Fukuhara N
Department of Neurology, National Saigata Hospital.
Rinsho Shinkeigaku. 1991 Nov;31(11):1252-4.
A 75-year-old man was admitted because of chest pain and gait disturbance. He noticed pain in the left anterior chest regardless of exercise 3 months prior to admission. Two months later, the chest became smart with motion, followed by sensory disturbance of the lower extremities. On admission, he was anemic. His lower extremities showed exaggerated deep tendon reflexes with positive Babinski signs and an impairment of superficial and deep sense with sensory ataxia. Muscular weakness, muscular wasting, or urinary disturbance was not found. An X-ray film of his thoracic spine disclosed compression fracture and protein content of his cerebrospinal fluid was increased. Magnetic resonance image (MRI) of the ill spines revealed fusion of the bodies of the fifth and sixth thoracic vertebrae with a low signal intensity on T1-weighted images and a partially high signal intensity on T2-weighted images. The intervertebral disc was destroyed. Although histological or bacteriological confirmation was absent, characteristic MRI findings were compatible with spinal osteomyelitis. After antibacterial chemotherapy, his clinical symptoms improved and he came to be able to walk again.
一名75岁男性因胸痛和步态障碍入院。入院前3个月，他无论是否运动都感到左前胸疼痛。两个月后，胸部运动时疼痛加剧，随后出现下肢感觉障碍。入院时，他有贫血症状。其下肢深腱反射亢进，巴宾斯基征阳性，浅感觉和深感觉均有障碍并伴有感觉性共济失调。未发现肌肉无力、肌肉萎缩或排尿障碍。胸椎X线片显示有压缩性骨折，脑脊液蛋白含量升高。病变脊柱的磁共振成像（MRI）显示胸5和胸6椎体融合，T1加权像上信号强度低，T2加权像上部分信号强度高。椎间盘被破坏。尽管缺乏组织学或细菌学证实，但典型的MRI表现符合脊髓骨髓炎。经过抗菌化疗后，他的临床症状有所改善，能够再次行走。
