Kanda Shotaro, Akiyama Toru, Chikuda Hirotaka, Yamaguchi Takehiko, Saita Kazuo
Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya-ku, Saitama 330-8503, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Case Rep Orthop. 2015;2015:926185. doi: 10.1155/2015/926185. Epub 2015 Sep 9.
Adult tethered cord syndrome (ATCS) is a rare entity that usually presents with multiple neurological symptoms, including lower extremity pain, backache, lower extremity muscle weakness, and bowel/bladder disturbances. Prompt surgical treatment is often necessary to avoid permanent sequelae. We report a 63-year-old man with sudden-onset severe right chest and upper back pain, followed by urinary retention. His initial workup included computed tomography of the abdomen and pelvis, which showed a presacral mass. His symptom-driven neurological workup focused on the cervical and thoracic spine, the results of which were normal. Pelvic radiographs and magnetic resonance imaging of the lumbosacral spine showed spina bifida occulta, meningocele, and presacral masses consistent with a teratomatous tumor. His symptoms, except for urinary retention, improved dramatically with surgical treatment. The excised specimen contained a teratomatous lesion plus an organized hematoma. Hematoma formation was suspected as the trigger of his sudden-onset right chest and upper back pain.
成人脊髓拴系综合征（ATCS）是一种罕见的疾病，通常表现为多种神经症状，包括下肢疼痛、背痛、下肢肌肉无力以及肠道/膀胱功能障碍。通常需要及时进行手术治疗以避免永久性后遗症。我们报告一例63岁男性，突发严重的右胸和上背部疼痛，随后出现尿潴留。其最初的检查包括腹部和骨盆计算机断层扫描，结果显示骶前肿块。他基于症状的神经学检查重点关注颈椎和胸椎，结果正常。骨盆X线片和腰骶椎磁共振成像显示隐性脊柱裂、脊膜膨出以及与畸胎瘤相符的骶前肿块。除尿潴留外，他的症状经手术治疗后显著改善。切除的标本包含一个畸胎瘤样病变以及一个机化血肿。怀疑血肿形成是其突发右胸和上背部疼痛的诱因。
