Haro Hirotaka, Domoto Toru, Maekawa Shingo, Horiuchi Tadahiro, Komori Hiromichi, Hamada Yoshiki
1 Department of Orthopaedic Surgery, Graduate School of Medicine, University of Yamanashi, Japan.
J Neurosurg Spine. 2008 Mar;8(3):300-4. doi: 10.3171/SPI/2008/8/3/300.
The authors describe 2 cases of thoracic disc herniation, resulting in acute myelopathy without bladder dysfunction or progressive muscular weakness; the herniated disc apparently resorbed without surgical intervention. Thoracic disc herniations are less frequent than cervical or lumbar disc herniations and are usually associated with severe neurological deficits. In these 2 cases, the herniated discs exhibited marked decreases in size, corresponding to a favorable clinical outcome within a few months after the initiation of conservative treatment with prostaglandin E(1) and/or steroids in conjunction with physical therapy. The authors conclude that thoracic herniated discs are capable of undergoing natural resorption and that conservative treatment could be indicated, even in the presence of moderate myelopathy, when the myelopathy is not accompanied by bladder dysfunction or progressive muscular weakness.
作者描述了2例胸椎椎间盘突出症病例,导致急性脊髓病,但无膀胱功能障碍或进行性肌无力;突出的椎间盘在未进行手术干预的情况下明显吸收。胸椎椎间盘突出症比颈椎或腰椎椎间盘突出症少见,且通常与严重的神经功能缺损有关。在这2例病例中,突出的椎间盘尺寸明显减小,这与在开始使用前列腺素E(1)和/或类固醇结合物理治疗进行保守治疗后的几个月内出现良好的临床结果相对应。作者得出结论,胸椎椎间盘突出症能够自然吸收,并且即使存在中度脊髓病,当脊髓病不伴有膀胱功能障碍或进行性肌无力时,也可考虑进行保守治疗。
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