Kizawa Memorial Hospital, Department of Orthopaedic Surgery, 590 Shimokobi, Kobichou, Minokamo City, Gifu 505-8503, Japan.
Bone Joint J. 2013 Oct;95-B(10):1388-91. doi: 10.1302/0301-620X.95B10.31222.
There have been a few reports of patients with a combination of lumbar and thoracic spinal stenosis. We describe six patients who suffered unexpected acute neurological deterioration at a mean of 7.8 days (6 to 10) after lumbar decompressive surgery. Five had progressive weakness and one had recurrent pain in the lower limbs. There was incomplete recovery following subsequent thoracic decompressive surgery. The neurological presentation can be confusing. Patients with compressive myelopathy due to lower thoracic lesions, especially epiconus lesions (T10 to T12/L1 disc level), present with similar symptoms to those with lumbar radiculopathy or cauda equina lesions. Despite the rarity of this condition we advise that patients who undergo lumbar decompressive surgery for stenosis should have sagittal whole spine MRI studies pre-operatively to exclude proximal neurological compression.
有一些报告称，一些患者同时患有腰椎和胸椎狭窄症。我们描述了六名患者，他们在腰椎减压手术后平均 7.8 天（6 至 10 天）后出现意外的急性神经恶化。五名患者出现进行性无力，一名患者出现下肢疼痛复发。随后进行的胸椎减压手术后，患者没有完全恢复。这种神经表现可能会令人困惑。由于下胸椎病变（T10 至 T12/L1 椎间盘水平）导致压迫性脊髓病的患者，尤其是上终丝病变的患者，其症状与腰椎神经根病或马尾病变相似。尽管这种情况很少见，但我们建议接受腰椎减压手术治疗狭窄症的患者应在术前进行全脊柱矢状 MRI 研究，以排除近端神经压迫。
