Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai, Osaka 591-8025, Japan.
Eur Spine J. 2010 Jul;19 Suppl 2(Suppl 2):S179-82. doi: 10.1007/s00586-010-1296-y. Epub 2010 Feb 4.
We report the case of a 50-year-old man presenting symptoms of autonomic dysreflexia associated with Charcot spine following complete C8 spinal cord injury. After posterior lumbar interbody fusion of L2/3 with simultaneous posterior instrumentation from L1 to L5, the patient recovered from the symptoms of autonomic dysreflexia. Although the patient began to faint when he sat up and transferred after surgery, it began to be resolved by continuous urinary catheterization, setting a limit to activity and prescription of alpha-, beta-stimulants. Within a few weeks after performing these treatment strategies, he could return to active wheelchair life, and no recurrence of any symptoms was noted at the 6-year follow-up. Although there are only a small number of cases with Charcot spine presenting autonomic dysreflexia, surgical stabilization of the affected lesion for patients with this condition should be recommended.
我们报告了一例 50 岁男性,因完全性 C8 脊髓损伤后出现夏科脊柱相关的自主神经反射障碍症状。行 L2/3 后路腰椎间融合术,同时从 L1 到 L5 行后路内固定后,患者的自主神经反射障碍症状得到缓解。尽管患者术后坐起和转移时开始出现晕厥,但通过持续的导尿、限制活动和开处 alpha、beta 兴奋剂后开始得到解决。在执行这些治疗策略后的几周内,他可以回到积极的轮椅生活中,在 6 年的随访中没有发现任何症状复发。虽然仅有少数夏科脊柱出现自主神经反射障碍的病例,但对于此类患者,建议对受累病变进行手术稳定。