两阶段减压治疗胸腰椎多节段椎管狭窄所致圆锥和马尾神经综合征合并症：1例报告

Two-stage decompression for combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis of the thoracolumbar spine: a case report.

作者信息

Hioki Akira, Miyamoto Kei, Hosoe Hideo, Fukuta Shoji, Shimizu Katsuji

机构信息

Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1 Yanagido, Gifu City, Gifu, Japan.

出版信息

Arch Orthop Trauma Surg. 2008 Sep;128(9):955-8. doi: 10.1007/s00402-007-0555-9. Epub 2008 Feb 19.

DOI:10.1007/s00402-007-0555-9

PMID:18283471

Abstract

INTRODUCTION

A case of combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis of the thoracolumbar spine is reported.

METHODS

A 76-year-old man with multilevel spinal canal stenosis of the thoracolumbar spine (Th11-12, L2-S) who showed symptoms of epiconus syndrome was reported. First, we performed anterior decompression and fusion at the thoracolumbar junction (decompression: Th11-12, fusion: Th10-L2), which ameliorated his symptom partially. However, he presented cauda equina symptoms. Then, he underwent posterior spinal decompression (L3-5) and fusion (Th12-L5).

RESULTS

After anterior decompression, several symptoms disappeared. However, motor and sensory disturbance below L4 and bladder-bowel disturbance remained. We then performed a secondary operation. At three years' follow-up, he was able to walk with the aid of a cane.

CONCLUSIONS

Combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis was treated by combined two-stage anterior and posterior decompression. In this case, multilevel decompression via anterior and posterior approaches was necessary to relieve the symptoms.

摘要

引言

报告一例因胸腰椎多节段椎管狭窄导致圆锥和马尾综合征合并的病例。

方法

报告一名76岁男性，患有胸腰椎（Th11 - 12，L2 - S）多节段椎管狭窄，表现为圆锥综合征症状。首先，我们在胸腰段交界处进行了前路减压和融合（减压：Th11 - 12，融合：Th10 - L2），这部分改善了他的症状。然而，他出现了马尾症状。随后，他接受了后路脊柱减压（L3 - 5）和融合（Th12 - L5）。