Rodgers Andrew M, Khauv Kim B
Fort Lee Chiropractic Associates, Fort Lee, New Jersey.
Private Practice, San Diego, California.
J Chiropr Med. 2017 Sep;16(3):242-245. doi: 10.1016/j.jcm.2017.02.002. Epub 2017 May 12.
The purpose of this case report was to describe a patient presenting with back pain subsequently diagnosed with thoracic schwannoma.
A 45-year-old male presented to a chiropractic practice with mid-back, low back, and sacroiliac pain. Orthopedic examination revealed joint dysfunction in the thoracic-sacroiliac region with normal findings on neurologic examination. An initial diagnosis of thoracic spinal pain and sacroiliac sprain and strain was made. At approximately 7 weeks of treatment, because of the patient's persistent pain, chest magnetic resonance imaging (MRI) was ordered by the chiropractic physician.
The chest MRI revealed an intradural extramedullary mass at the T5 level creating a marked compression of the spinal cord. A thoracic MRI was conducted 2 days later confirming the presence of the tumor. The patient was successfully treated with spinal surgery to remove a schwannoma.
Mechanical spinal pain is a common symptom in patients presenting to chiropractic offices and may present concurrent with other pathology. In the presence of unresolved persistent thoracic pain, clinicians should investigate other potential causes.
本病例报告旨在描述一名出现背痛并随后被诊断为胸段神经鞘瘤的患者。
一名45岁男性因中背部、下背部及骶髂部疼痛就诊于一家整脊诊所。骨科检查发现胸段至骶髂部区域存在关节功能障碍，而神经学检查结果正常。初步诊断为胸段脊柱疼痛以及骶髂部扭伤和劳损。在治疗约7周时，由于患者疼痛持续，整脊医生安排了胸部磁共振成像（MRI）检查。
胸部MRI显示T5水平存在硬膜内髓外肿块，对脊髓造成明显压迫。两天后进行了胸段MRI检查，证实了肿瘤的存在。患者通过脊柱手术成功切除神经鞘瘤。
机械性脊柱疼痛是前往整脊诊所就诊患者的常见症状，可能与其他病理情况同时出现。在存在未缓解的持续性胸痛时，临床医生应调查其他潜在病因。
