Oe T, Hoshino Y, Kurokawa T
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1990 Jan;64(1):43-9.
Idiopathic herniation of the spinal cord is a very rare disease, only 2 cases being so far reported in the literature. A 61-year-old man with a gradual loss of power in his lower extremities was diagnosed as intradural arachnoid cyst, and underwent operation. During operation, not only an arachnoid cyst was observed dorsally, but was also duplicated the dura mater ventrally. In the latter lesion, a ventral part of the spinal cord was herniated from a defected area of the dural inner layer. Although this dural inner layer as well as the arachnoid cyst was resected, his clinical symptoms remained unchanged after operation. When a shift of the spinal cord is detected in an image, we should precisely determine the relationship between the spinal cord and the dura mater during operation with consideration of a possibility of the presence of idiopathic herniation of the spinal cord.
特发性脊髓疝是一种非常罕见的疾病,迄今为止文献中仅报道过2例。一名61岁男性,下肢力量逐渐丧失,被诊断为硬脊膜内蛛网膜囊肿,并接受了手术。手术过程中,不仅在背侧观察到一个蛛网膜囊肿,而且在腹侧还发现硬脑膜重复。在后一种病变中,脊髓腹侧部分从硬脑膜内层的缺损区域疝出。尽管切除了硬脑膜内层以及蛛网膜囊肿,但术后他的临床症状仍未改变。当在图像中检测到脊髓移位时,我们应在手术过程中精确确定脊髓与硬脑膜之间的关系,同时考虑存在特发性脊髓疝的可能性。