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长期血液透析患者棕色瘤继发脊髓压迫症:一例报告

Spinal cord compression secondary to brown tumour in a patient on long-term haemodialysis: a case report.

作者信息

Mak K C, Wong Y W, Luk K D K

机构信息

Department of Orthopaedics and Traumatology, Queen Mary Hospital, University of Hong Kong, Hong Kong.

出版信息

J Orthop Surg (Hong Kong). 2009 Apr;17(1):90-5. doi: 10.1177/230949900901700120.

Abstract

Brown tumours may occur secondary to hyperparathyroidism in patients with chronic renal failure (CRF). Diagnosing a spinal brown tumour causing cord compression requires a high index of suspicion. We report a 65-year-old woman, who had been on haemodialysis for CRF for over 10 years, who presented with leg weakness and back pain over the thoracolumbar junction. She had a brown tumour at T8 causing subacute spinal cord compression. Ambulation was regained after surgical decompression and stabilisation. Adherence to the National Kidney Foundation guidelines in the management of patients with CRF may prevent renal osteodystrophy. Treatment of spinal brown tumour depends on the severity of the neurological deficit. Remineralization is expected after correction of the parathyroid level, thus negating the need for total excision of the parathyroid glands.

摘要

棕色瘤可能继发于慢性肾衰竭(CRF)患者的甲状旁腺功能亢进。诊断导致脊髓受压的脊柱棕色瘤需要高度的怀疑指数。我们报告一名65岁女性,因CRF接受血液透析超过10年,出现胸腰段交界部位的腿部无力和背痛。她在T8处有一个棕色瘤,导致亚急性脊髓受压。手术减压和稳定治疗后恢复了行走能力。在CRF患者管理中遵循国家肾脏基金会指南可能预防肾性骨营养不良。脊柱棕色瘤的治疗取决于神经功能缺损的严重程度。甲状旁腺水平纠正后有望实现再矿化,因此无需完全切除甲状旁腺。

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