Service de neurochirurgie, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Association des Jeunes Chirurgiens du Rachis (AJCR), 237, rue de Bercy, 75012 Paris, France.
Orthop Traumatol Surg Res. 2013 Dec;99(8):983-6. doi: 10.1016/j.otsr.2013.08.006. Epub 2013 Nov 5.
As spinal surgery in elderly patients is becoming increasingly frequent, comorbidities likely to be decompensated after such procedures must be kept in mind. We report here the case of an 82-year-old woman who presented rapidly progressive spinal cord compression following lumbar surgery for radiculopathy. Investigations showed a thoracic intradural extramedullary compressive lesion, which after removal turned out to be a meningioma. We suggest that radiculopathy and non-specific degenerative modifications partially masked this lesion, and that lumbar surgery caused this acute neurological deterioration. Therefore, we advice caution in older patients among whom such ambiguous clinical presentation is frequent.
随着老年患者脊柱手术的日益增多,必须牢记此类手术后可能恶化的合并症。我们在此报告一例 82 岁女性患者,其在因神经根病而行腰椎手术后出现迅速进展的脊髓压迫。检查显示胸段硬脊膜外髓内压迫性病变,切除后证实为脑膜瘤。我们认为神经根病和非特异性退行性改变部分掩盖了这一病变,腰椎手术导致了这一急性神经功能恶化。因此,我们建议在这种表现不明确的情况较为常见的老年患者中谨慎行事。