Miwa Toshitada, Yamashita Tomoya, Sakaura Hironobu, Ohzono Kenji, Ohwada Tetsuo
Department of Orthopaedic Surgery, Kansai Rosai Hospital, Japan.
Intern Med. 2013;52(14):1621-4. doi: 10.2169/internalmedicine.52.9379. Epub 2013 Jul 15.
Steroid therapy is commonly prescribed, although a variety of complications have been reported. Among such complications, spinal epidural lipomatosis is rare and difficult to diagnose before paraparesis occurs. The purpose of this report is to present a rare but catastrophic complication of steroid therapy. A 64-year-old woman undergoing long-term steroid therapy suffered from an osteoporotic vertebral compression fracture and was unable to walk due to paraparesis. Magnetic resonance imaging (MRI) demonstrated a D7 compression fracture and stored epidural adipose tissue between D5 and D8. After surgery, the patient was able to walk with double canes. This case indicates that long-term steroid use has the potential to induce paraparesis.
类固醇疗法是常用的治疗方法,尽管已有多种并发症的报道。在这些并发症中,脊柱硬膜外脂肪增多症较为罕见,且在出现下肢轻瘫之前很难诊断。本报告的目的是介绍一种罕见但极具灾难性的类固醇疗法并发症。一名64岁长期接受类固醇治疗的女性患有骨质疏松性椎体压缩骨折,因下肢轻瘫而无法行走。磁共振成像(MRI)显示D7椎体压缩骨折,且在D5至D8之间有硬膜外脂肪组织蓄积。手术后,患者能够借助双拐行走。该病例表明长期使用类固醇有可能诱发下肢轻瘫。