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类固醇诱导性轻截瘫:合并胸椎中段楔形畸形的脊髓硬膜外脂肪增多症。

Steroid-induced paraparesis: spinal epidural lipomatosis complicated by a wedge deformity of the middle thoracic vertebrae.

作者信息

Miwa Toshitada, Yamashita Tomoya, Sakaura Hironobu, Ohzono Kenji, Ohwada Tetsuo

机构信息

Department of Orthopaedic Surgery, Kansai Rosai Hospital, Japan.

出版信息

Intern Med. 2013;52(14):1621-4. doi: 10.2169/internalmedicine.52.9379. Epub 2013 Jul 15.

Abstract

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.

摘要

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。

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