与颈椎间盘突出症相关的非创伤性急性截瘫
Nontraumatic acute paraplegia associated with cervical disk herniation.
作者信息
Liu Chao, Huang Yue, Cai Hong-Xin, Fan Shun-Wu
机构信息
Department of Orthopaedics, Sir Run Run Shaw Hospital, Institute of Clinical Medicine of Zhejiang University, Hang Zhou, China.
出版信息
J Spinal Cord Med. 2010;33(4):420-4. doi: 10.1080/10790268.2010.11689721.
Abstract
BACKGROUND
Acute paraplegia is a true emergency. It is often the result of trauma but is rarely reported in association with cervical disk herniation in patients without antecedent injury.
METHODS
Case report.
FINDINGS
This 75-year-old man presented with acute paraplegia due to severe compression of the spinal cord by herniation of the C4-C5 cervical disk. He underwent emergency diskectomy and anterior fusion. Postoperatively, his neurologic functions improved gradually.
CONCLUSIONS
Cervical disk herniation should be considered in the differential diagnosis of nontraumatic acute paraplegia. Pre-existing narrowed canal is an important predisposing factor and excessive neck movements are believed to be triggering factors. Immediate early decompressive surgery is recommended to avoid irreversible progression of neurologic deficit.
摘要
背景
急性截瘫是一种真正的急症。它通常是创伤的结果，但在没有既往损伤的患者中，与颈椎间盘突出相关的情况很少被报道。
方法
病例报告。
结果
这名75岁男性因C4 - C5颈椎间盘突出导致脊髓严重受压而出现急性截瘫。他接受了急诊椎间盘切除术和前路融合术。术后，他的神经功能逐渐改善。
结论
在非创伤性急性截瘫的鉴别诊断中应考虑颈椎间盘突出。先前存在的椎管狭窄是一个重要的诱发因素，而过度的颈部活动被认为是触发因素。建议立即进行早期减压手术，以避免神经功能缺损的不可逆进展。
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本文引用的文献
1
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Am J Emerg Med. 2009 Jul;27(6):753.e3-4. doi: 10.1016/j.ajem.2008.10.003.
2
Clinical reasoning: a 59-year-old woman with acute paraplegia.
Neurology. 2007 Dec 11;69(24):E41-7. doi: 10.1212/01.wnl.0000291014.07901.59.
3
Acute spontaneous spinal subdural hematoma presenting as paraplegia: a rare case.以截瘫为表现的急性自发性脊髓硬膜下血肿：1例罕见病例。
Spine (Phila Pa 1976). 2007 Oct 1;32(21):E619-22. doi: 10.1097/BRS.0b013e318154c618.
4
Acute flaccid paraplegia: a rare complication of meningococcal meningitis.急性弛缓性截瘫：脑膜炎球菌性脑膜炎的一种罕见并发症。
Spinal Cord. 2008 Apr;46(4):314-6. doi: 10.1038/sj.sc.3102120. Epub 2007 Sep 11.
5
Spinal cord injury medicine. 2. Acute care management of traumatic and nontraumatic injury.脊髓损伤医学。2. 创伤性和非创伤性损伤的急性护理管理。
Arch Phys Med Rehabil. 2007 Mar;88(3 Suppl 1):S55-61. doi: 10.1016/j.apmr.2006.12.002.
6
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Spine (Phila Pa 1976). 2005 Aug 15;30(16):E481-3. doi: 10.1097/01.brs.0000174284.08440.1e.
7
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8
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