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医源性脊柱骨折致强直性脊柱炎患者死亡

Leading a Patient of Ankylosing Spondylitis to Death by Iatrogenic Spinal Fracture.

作者信息

Oh Jae-Sang, Doh Jae-Won, Shim Jai-Joon, Lee Kyeong-Seok

机构信息

Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.

出版信息

Korean J Spine. 2016 Jun;13(2):80-2. doi: 10.14245/kjs.2016.13.2.80. Epub 2016 Jun 30.

Abstract

Fractures in ankylosing spondylitis (AS) are often difficult to identify and treat. If combined with osteoporosis, the spine becomes weaker and vulnerable to minor trauma. An 83-year-old woman with a history of chronic AS and severe osteoporosis developed paraparesis and voiding difficulty for 4 days prior. She had been placed in the lateral decubitus position in a bedridden state in a convalescent hospital due to the progressive paraparesis. The laboratory findings showed CO2 retention in the arterial blood gas analysis. After the patient was transferred to the computed tomography (CT) room, a CT was taken in the supine position. Approximately half an hour later, the resident in our neurosurgical department checked on her, and the neurological examination showed a complete paraplegic state. She was treated conservatively and finally expired 20 days later.

摘要

强直性脊柱炎(AS)骨折往往难以识别和治疗。若合并骨质疏松,脊柱会变得更脆弱,易受轻微创伤。一名83岁女性,有慢性AS病史和严重骨质疏松,4天前出现双下肢轻瘫和排尿困难。因进行性双下肢轻瘫,她在康复医院卧床时一直处于侧卧位。实验室检查结果显示动脉血气分析存在二氧化碳潴留。患者被转至计算机断层扫描(CT)室后,在仰卧位进行了CT检查。大约半小时后,我们神经外科的住院医师对她进行检查,神经检查显示为完全性截瘫状态。她接受了保守治疗,最终在20天后死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c91/4949174/fd5823bc9720/kjs-13-80-g001.jpg

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