Doléagbénou A K, Mukengeshay Ntalaja J, Derraz S, El Ouahabi A, El Khamlichi A
Service de neurochirurgie, hôpital des spécialités Rabat, CHU Ibn-Sina, Rabat, Maroc.
Neurochirurgie. 2012 Aug;58(4):263-7. doi: 10.1016/j.neuchi.2012.03.009. Epub 2012 May 1.
Langerhans cell histiocytosis (LCH), a disorder of the phagocytic system, is a rare condition. Moreover, spinal involvement causing myelopathy is even rare and unusual. Here, we report a case of atypical LCH causing myelopathy, which was subsequently treated by corporectomy and fusion. An 8-year-old boy presented with 3 weeks of severe neck pain and limited neck movement accompanying upper and lower limbs motor weakness. CT scans revealed destruction of C5 body and magnetic resonance imaging showed a tumoral process at C5 with cord compression. Interbody fusion using anterior cervical plate packed by autologus iliac bone was performed. Pathological examination confirmed the diagnosis of LCH. After the surgery, the boy recovered from radiating pain and motor weakness of limbs. Despite the rarity of the LCH in the cervical spine, it is necessary to maintain our awareness of this condition. When neurologic deficits are present, operative treatment should be considered.
朗格汉斯细胞组织细胞增多症(LCH)是一种吞噬系统疾病,较为罕见。此外,导致脊髓病的脊柱受累情况更是罕见且不常见。在此,我们报告一例导致脊髓病的非典型LCH病例,该病例随后接受了椎体切除术和融合术治疗。一名8岁男孩出现3周的严重颈部疼痛,颈部活动受限,并伴有上下肢运动无力。CT扫描显示C5椎体破坏,磁共振成像显示C5处有肿瘤性病变并伴有脊髓受压。采用自体髂骨填充前路颈椎钢板进行椎间融合术。病理检查确诊为LCH。手术后,男孩的放射性疼痛和肢体运动无力症状有所恢复。尽管LCH在颈椎中较为罕见,但我们仍有必要对这种疾病保持警惕。当出现神经功能缺损时,应考虑手术治疗。