Tauchi Ryoji, Imagama Shiro, Satake Kotaro, Iwase Toshiki, Ishiguro Naoki
Nagoya University Graduate School of Medicine, Department of Orthopaedic Surgery, Nagoya, Japan.
Turk Neurosurg. 2014;24(1):98-101. doi: 10.5137/1019-5149.JTN.7615-12.2.
The authors describe the clinical findings, radiographic appearance and surgical treatment of a spinal epidural hematoma (SEH) associated with spinal fracture in diffuse idiopathic skeletal hyperostosis (DISH). An 81-year-old male patient injured after falling from a 2.5 m tree presented with severe back pain. On plain radiographs and CT images, DISH with anterolateral osteophytes and fused thoracolumbar vertebrae was found along with a T12 fracture. Patient was initially treated with bed rest followed by placement into a body cast. Three weeks later, he presented with incomplete paraplegia of his lower limbs. CT images did not reveal any fracture displacement, but MRI images showed an epidural hematoma compressing the dura mater. The patient was successfully treated by posterior fixation surgery using pedicle screws and rod with vertebroplasty. We aimed to report a unique case of a SEH complicating a spinal fracture in DISH.
作者描述了弥漫性特发性骨肥厚（DISH）中与脊柱骨折相关的脊髓硬膜外血肿（SEH）的临床发现、影像学表现及手术治疗情况。一名81岁男性患者从2.5米高的树上跌落受伤，出现严重背痛。在X线平片和CT图像上，发现有DISH伴前外侧骨赘及胸腰椎融合，同时存在T12骨折。患者最初接受卧床休息治疗，随后佩戴支具。三周后，他出现下肢不完全性截瘫。CT图像未显示任何骨折移位，但MRI图像显示硬膜外血肿压迫硬脑膜。该患者通过使用椎弓根螺钉和棒并结合椎体成形术的后路固定手术成功治愈。我们旨在报告DISH中脊柱骨折并发SEH的一个独特病例。
