上颈椎异常导致的垂腕和手指肌肉无力。
Wrist drop and muscle weakness of the fingers induced by an upper cervical spine anomaly.
作者信息
Tsunoda Daisuke, Iizuka Haku, Iizuka Yoichi, Nishinome Masahiro, Takagishi Kenji
机构信息
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
出版信息
Eur Spine J. 2014 May;23 Suppl 2:218-21. doi: 10.1007/s00586-013-3038-4. Epub 2013 Sep 23.
PURPOSE
This report presents a case of wrist drop and muscle weakness of the fingers as a false localizing sign induced by stenosis of the upper cervical spine caused by a bony anomaly.
METHODS
A 77-year-old male complained of severe muscle weakness of the right hand. Cervical spine MRI showed a severe and sharp compression of the spinal cord from the dorsal side between C2 and C3 with intramedullary intensity changes and mild stenosis at C3/4 and C4/5.
RESULTS
The patient underwent laminectomy of C2, cranial side laminotomy of C3, and laminectomy of C4. Decompression of the spinal cord was demonstrated 1 year after surgery. The patient achieved full recovery of the muscle weakness 1 year after undergoing surgery.
CONCLUSIONS
The pathophysiology of false localizing signs remains controversial; however, we believe that this unusual compression pattern and level had the possibility to induce atypical myelopathies such as drop hand and finger of the unilateral hand in this case.
目的
本报告介绍了一例因骨异常导致上颈椎狭窄引起的垂腕和手指肌肉无力作为假定位体征的病例。
方法
一名77岁男性主诉右手严重肌肉无力。颈椎MRI显示C2和C3之间脊髓背侧严重且锐利受压，伴有髓内信号改变，C3/4和C4/5轻度狭窄。
结果
患者接受了C2椎板切除术、C3颅侧椎板切开术和C4椎板切除术。术后1年显示脊髓减压。患者术后1年肌肉无力完全恢复。
结论
假定位体征的病理生理学仍存在争议；然而，我们认为这种不寻常的压迫模式和水平有可能在该病例中诱发非典型脊髓病，如单侧手的垂腕和手指无力。
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