Lafforgue P, Daumen-Legre V, Schiano A, Peragut J C, Acquaviva P C
Service de Rhumatologie et d'Algologie, CHU La Timone, Marseille.
Rev Rhum Mal Osteoartic. 1990 Oct;57(9):619-25.
Three new cases of neurological complication by osteoporotic compression are reported. They are: a medullar compression by compression of D12 in a 66 year old woman, a deficient cruralgia by compression of L1 in a 67 year old man, and another deficient cruralgia due to the compression of L3 and L4 in a 55 year old woman. The literature presents 16 cases of neurological compressions by vertebral compressions attributed to the osteoporosis: two in 1958, and the others as from 1987. The only recently recognized feature of these complications can be explained by the axiom according to which "there are no neurological complications in the course of osteoporotic compressions" and by the introduction of new diagnosis techniques. However, the critical analysis of the published cases enables us to retain only 11 indisputable cases which, with our three observations, allows us to define certain features: the osteoporosis does not have any particularity compared to the uncomplicated form; the dorsolumbar junction is preferentially affected; the neurological complication occurs progressively and belatedly; the usual mechanism is the recoil of one of posterior vertebral corners, different from the globally convex bulging of tumoral compressions: it could be an element of the differential diagnosis. The surgical treatment gives better results.
报告了3例骨质疏松性压缩导致的神经并发症新病例。它们分别是：一名66岁女性因第12胸椎压缩导致脊髓受压，一名67岁男性因第1腰椎压缩导致股神经痛，以及一名55岁女性因第3和第4腰椎压缩导致股神经痛。文献报道了16例因骨质疏松导致椎体压缩引起的神经受压病例：1958年有2例，其余病例自1987年起。这些并发症最近才被认识到的唯一特征，可以用“骨质疏松性压缩过程中不存在神经并发症”这一公理以及新诊断技术的引入来解释。然而，对已发表病例的批判性分析使我们只能保留11例无可争议的病例，加上我们的3例观察病例，使我们能够确定某些特征：与无并发症形式相比，骨质疏松症没有任何特殊性；胸腰段交界处优先受累；神经并发症进展缓慢且出现较晚；常见机制是椎体后角之一的回弹，这与肿瘤性压缩的整体凸性隆起不同：这可能是鉴别诊断的一个因素。手术治疗效果更好。
