颈椎胸椎后路减压并器械融合手术治疗后纵韧带骨化症患者术后因久坐导致神经功能恶化：两例报告
Neurological deterioration induced by sitting in patients after cervicothoracic posterior decompression with instrumented fusion surgery for ossification of the longitudinal ligament: two cases reports.
作者信息
Koda Masao, Mannoji Chikato, Inada Taigo, Kamiya Koshiro, Ota Mitsutoshi, Maki Satoshi, Takahashi Kazuhisa, Yamazaki Masashi, Aramomi Masaaki, Ikeda Osamu, Furuya Takeo
机构信息
Departments of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-K, Chiba, 260-8670, Japan.
Chiba Aoba Municipal Hospital, Chiba, Japan.
出版信息
BMC Res Notes. 2015 Apr 9;8:133. doi: 10.1186/s13104-015-1106-z.
BACKGROUND
We report on Japanese patients who showed neurological deterioration induced by sitting after cervicothoracic posterior decompression with instrumented fusion, but showed immediate neurological recovery after bed rest.
CASE PRESENTATION
Patients showed incomplete paraparesis caused by the ossification of the posterior longitudinal ligament at uppermost thoracic spine. Cervicothoracic posterior decompression with instrumented fusion was performed. Postoperatively, the patients showed partial paraparesis when they were sitting. They showed rapid recovery from lower extremity paralysis upon lying down. After strict bed rest for one month, those patients showed no apparent development of paralysis during sitting.
CONCLUSION
In patients with postoperative residual anterior spinal cord compression, micromotion might exacerbate neurological symptoms.
背景
我们报告了一些日本患者，他们在接受颈胸段后路减压并器械融合术后，坐位时出现神经功能恶化，但卧床休息后神经功能立即恢复。
病例报告
患者因上胸椎后纵韧带骨化导致不完全性双下肢轻瘫。进行了颈胸段后路减压并器械融合术。术后，患者坐位时出现部分双下肢轻瘫。躺下后下肢麻痹迅速恢复。严格卧床休息一个月后，这些患者坐位时未出现明显的麻痹进展。
结论
在术后残留脊髓前方压迫的患者中，微动可能会加重神经症状。
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