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颈椎骨松质游离体增大合并脊髓压迫。

Enlargement of an osseous loose body in the cervical spine with cord compression.

机构信息

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita 0108543, Japan.

出版信息

Spine J. 2009 Nov;9(11):e11-4. doi: 10.1016/j.spinee.2009.06.015. Epub 2009 Aug 6.

Abstract

BACKGROUND CONTEXT

Loose bodies in the spinal canal are extremely rare, with only two cases reported previously in the literature.

PURPOSE

To report a rare case of an osseous loose body in the cervical spine with radiographic evidence of dramatic enlargement of the loose body in the spinal canal over the course of 9 years.

STUDY DESIGN/SETTING: Case report.

PATIENT SAMPLE

A 50-year-old man presented with progressive numbness and weakness of the upper and lower extremities and swaying gait in 2007. He had a history of temporary incomplete tetraplegia after a fall in 1998. Magnetic resonance imaging revealed enlargement of the posterior mass-occupying lesion compressing the cord at C5-C6 over the course of 9 years.

OUTCOME MEASURES

Neurological examination with motor and sensory status.

RESULTS

Posterior decompressive laminectomy was performed. An isolated, smooth-surfaced, bony, hard mass was found between the ligamentum flavum and facet joint and removed. Histological examination demonstrated trabecular bone and peripheral cartilage mixed with fibrous and fibrocartilaginous tissue. Clinical evaluation of the patient 6 months postoperatively showed total resolution of neurological symptoms.

CONCLUSION

We report herein an extremely rare case of an osseous loose body in the spinal canal with cord compression. This report represents the first documented case of growth of a loose body in the spinal canal.

摘要

背景

椎管内游离体极为罕见,文献中此前仅报告过两例。

目的

报告一例罕见的颈椎骨游离体病例,影像学证据表明,该游离体在椎管内的体积在 9 年内显著增大。

研究设计/设置:病例报告。

患者样本

一名 50 岁男性,于 2007 年出现进行性上下肢麻木无力和摇摆步态。他曾于 1998 年因跌倒而出现短暂性不完全四肢瘫痪。磁共振成像显示,在 9 年内 C5-C6 节段的脊髓受压的后质占位病变体积增大。

结果测量

神经学检查,包括运动和感觉状态。

结果

行后路减压椎板切除术。发现一个孤立的、表面光滑的骨硬性肿块位于黄韧带和小关节之间,并将其切除。组织学检查显示小梁骨和周围软骨混合有纤维和纤维软骨组织。术后 6 个月对患者进行临床评估显示,所有神经症状均完全缓解。

结论

我们报告了一例极其罕见的椎管内骨游离体伴脊髓压迫病例。本报告代表了首例有记录的椎管内游离体生长的病例。

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