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经皮椎体成形术后水泥渗漏导致亚急性进行性上升性脊髓病的罕见表现。

A rare presentation of subacute progressive ascending myelopathy secondary to cement leakage in percutaneous vertebroplasty.

机构信息

From the Department of Physical Medicine & Rehabilitation (RPB, AB, SMV, AC, JG, RT) and Department of Radio-diagnosis (SM), Christian Medical College, Vellore, Tamil Nadu, India.

出版信息

Am J Phys Med Rehabil. 2014 May;93(5):431-6. doi: 10.1097/PHM.0000000000000028.

Abstract

Percutaneous vertebroplasty is used to manage osteoporotic vertebral body compression fractures. Although it is relatively safe, complications after vertebroplasty ranging from minor to devastatingly major ones have been described. Cement leakage into the spinal canal is one such complication. Subacute progressive ascending myelopathy is an infrequent neurologic complication after spinal cord injury, typically presenting as ascending neurologic deficit within weeks after the initial insult. The precise cause of subacute progressive ascending myelopathy still remains an enigma, considering the rarity of this disorder. The authors present the case of a 62-yr-old woman with osteoporotic vertebral fracture who underwent percutaneous vertebroplasty and developed T6 complete paraplegia because of cement leakage. A few weeks later, the neurologic level ascended to higher cervical level (C3). To date, no case of subacute progressive ascending myelopathy secondary to cement leakage after percutaneous vertebroplasty has been reported. Literature is reviewed regarding subacute progressive ascending myelopathy, and the rehabilitation challenges in the management of this patient are discussed.

摘要

经皮椎体成形术用于治疗骨质疏松性椎体压缩性骨折。虽然它相对安全,但已有报道称经皮椎体成形术后会出现从轻微到严重的并发症。骨水泥渗漏到椎管就是其中一种并发症。亚急性进行性上升性脊髓病是脊髓损伤后的一种罕见神经系统并发症,通常在初次损伤后数周内出现上升性神经功能缺损。考虑到这种疾病的罕见性,亚急性进行性上升性脊髓病的确切病因仍然是个谜。作者报告了一例 62 岁女性骨质疏松性椎体骨折患者,行经皮椎体成形术后因骨水泥渗漏导致 T6 完全截瘫。几周后,神经功能水平上升至更高的颈椎水平(C3)。迄今为止,尚无经皮椎体成形术后骨水泥渗漏导致亚急性进行性上升性脊髓病的病例报告。本文回顾了亚急性进行性上升性脊髓病的文献,并讨论了该患者管理中的康复挑战。

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