Adeleye Amos O, Ogbole Godwin I
Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan, University College Hospital, UCH, Ibadan, Nigeria,
Neurosurg Rev. 2015 Jul;38(3):579-83; discussion 583. doi: 10.1007/s10143-015-0618-2. Epub 2015 Feb 21.
Surgical intervention is not so commonly deployed for idiopathic syringomyelia, even the symptomatic ones; is only undertaken, in the current era, after thorough clinical evaluation and extensive high-resolution neuroimaging; and is more assuredly performed, high-tech, in health facilities in the developed world with cutting edge logistic supports. In the practice environment of a low-resource African developing country, a 41-year-old young man recently presented in severe clinical-neurological deficit, Nurick grade 5, with an extensive cervical-medullary idiopathic syringomyelia. In spite of severe preoperative and intraoperative resource limitations, he successfully underwent spinal surgical decompression, fenestration of syrinx, and expansile duraplasty. He improved clinically postoperatively and achieved mobility, Nurick grade 3, before hospital discharge. He sustained this improvement, Nurick grade 3 to 2, 20 months post-op. He is now independent, needing only a walking stick to aid ambulation, and an MRI at this time showed only minimal focal post-op changes but total disappearance of the syrinx.
对于特发性脊髓空洞症，即使是有症状的患者，手术干预也并不常用；在当前时代，只有在经过全面的临床评估和广泛的高分辨率神经影像学检查后才会进行手术；而且，在具备前沿后勤支持的发达国家的医疗机构中，手术实施更有保障且技术含量高。在资源匮乏的非洲发展中国家的实际医疗环境中，一名41岁的年轻男子最近因严重的临床神经功能缺损（努里克5级）前来就诊，患有广泛的颈髓特发性脊髓空洞症。尽管术前和术中资源严重受限，但他还是成功接受了脊柱手术减压、脊髓空洞开窗和硬脑膜扩大修补术。术后他的临床症状有所改善，出院前达到了可活动状态（努里克3级）。术后20个月，他的病情持续改善，从努里克3级变为2级。他现在能够独立生活，仅需一根拐杖辅助行走，此时的磁共振成像显示术后仅有轻微的局部改变，但脊髓空洞已完全消失。
