骶管阻滞术后迟发性脊髓蛛网膜炎
Delayed occurrence of spinal arachnoiditis following a caudal block.
作者信息
Na Eun Hye, Han Soo Jeong, Kim Myung Hyun
机构信息
School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
出版信息
J Spinal Cord Med. 2011 Nov;34(6):616-9. doi: 10.1179/2045772311Y.0000000035.
CONTEXT
Spinal arachnoiditis is a rare disease caused by fibrosis and adhesion of the arachnoid membrane due to chronic inflammation. The causes of arachnoiditis are infection, spinal surgery, intraspinal injection of steroid or myelography dye, and spinal anesthesia.
METHOD
Case report.
FINDINGS
A 60-year-old woman presented with progressive weakness and sensory change of both legs and urinary symptoms. She had received a single caudal block 6 months before symptom onset. Magnetic resonance imaging of the thoraco-lumbar spine showed an intradural extramedullary tumor at the T5-T7 level. She underwent laminectomy and tumor resection. The pathological finding was arachnoiditis. After surgery, a rehabilitation program of strengthening exercises of both lower extremities and gait training was started. At 2-month follow-up, she was able to walk with orthoses and performed daily activities with minimal assistance.
CONCLUSION
Symptoms of spinal arachnoiditis occurred 6 months after a single caudal block in this woman. Clinicians should be aware of this possible delayed complication.
背景
脊髓蛛网膜炎是一种罕见疾病，由慢性炎症导致蛛网膜纤维化和粘连引起。蛛网膜炎的病因包括感染、脊柱手术、椎管内注射类固醇或脊髓造影染料以及脊髓麻醉。
方法
病例报告。
结果
一名60岁女性出现双下肢进行性无力、感觉改变及泌尿系统症状。症状出现前6个月她接受过单次骶管阻滞。胸腰椎磁共振成像显示T5 - T7水平硬膜内髓外肿瘤。她接受了椎板切除术和肿瘤切除术。病理结果为蛛网膜炎。术后开始了双下肢强化锻炼和步态训练的康复计划。在2个月的随访中，她能够借助矫形器行走，并在极少帮助下进行日常活动。
结论
该女性在单次骶管阻滞后6个月出现脊髓蛛网膜炎症状。临床医生应意识到这种可能的延迟并发症。
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