Shimizu Satoru, Miyazaki Tomoko, Mochizuki Takahiro, Oka Hidehiro
Department of Neurosurgery, Yokohama Stroke and Brain Center, l-2-1 Takigashira, Isogo-ku, Yokohama, Kanagawa, 235-0012, Japan,
Eur Spine J. 2014 May;23 Suppl 2:197-200. doi: 10.1007/s00586-013-2966-3. Epub 2013 Aug 24.
We present a case with spinal myolipoma that was unique in its anatomical composition and symptomatology.
An 18-year-old male presented with urinary retention and buttock pain exacerbated by standing on tiptoe underwent untethering of the low-set conus associated with a sacral fatty tract. Electrical stimulation of the spinal roots beside the upper conus induced anomalous caudal movement of the conus and contraction of the gastrocnemius muscle. In the lower conus, an ectopic muscle bridging the conus and dura was found, and the tissue contracted upon electrical stimulation. The histopathological diagnosis was myolipoma involving mature striated muscle and fat cells. Postoperatively his buttock pain was relieved immediately, but urinary retention persisted.
We posit that his buttock pain, exacerbated by standing on tiptoe, was due to traction of the conus by contraction of the ectopic muscle that was aberrantly innervated from the sacral spinal roots.
我们报告一例脊髓脂肪瘤病例，其解剖结构和症状学表现独特。
一名18岁男性，因踮脚站立会加重的尿潴留和臀部疼痛前来就诊，接受了低位圆锥与骶尾部脂肪束松解术。对上圆锥旁的脊神经根进行电刺激时，圆锥出现异常的尾端移动，腓肠肌收缩。在下圆锥处，发现一块连接圆锥和硬脑膜的异位肌肉，电刺激时该组织会收缩。组织病理学诊断为包含成熟横纹肌和脂肪细胞的脂肪瘤。术后其臀部疼痛立即缓解，但尿潴留仍持续存在。
我们认为，他踮脚站立时加重的臀部疼痛，是由于异位肌肉收缩牵拉圆锥所致，该异位肌肉由骶神经根异常支配。
