微创经椎间孔腰椎椎间融合术后横纹肌溶解症：病例报告
Rhabdomyolysis following minimally invasive transforaminal lumbar interbody fusion: Case report.
作者信息
Makler Vyacheslav, Norregaard Thorkild Vad
机构信息
Section of Neurological Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States.
Division of Neurological Surgery, University of Missouri School of Medicine, Columbia, Missouri, United States.
出版信息
Surg Neurol Int. 2018 Mar 1;9:50. doi: 10.4103/sni.sni_481_17. eCollection 2018.
BACKGROUND
Rhabdomyolysis results from the release of large quantities of muscle cell contents into plasma resulting in a classic triad of symptoms - muscle pain, weakness, and brown urine. Only a handful of rhabdomyolysis cases occurring after spinal surgery have been reported.
CASE DESCRIPTION
A 36-year-old male underwent an uneventful right-sided, minimally invasive transforaminal lumbar interbody fusion (miTLIF) for intractable lower back pain and right lower extremity radiculopathy attributed to L4-S1 degenerative spondylosis (DS). Postoperatively, the patient complained of intractable lower extremity pain resistant to medical management. He was subsequently diagnosed with rhabdomyolysis, and aggressive intravenous fluid resuscitation resulted in complete recovery.
CONCLUSIONS
Rhabdomyolysis should be diagnosed and treated promptly with aggressive intravenous fluid resuscitation to avoid acute kidney injury following miTLIF surgery.
背景
横纹肌溶解症是由于大量肌肉细胞内容物释放到血浆中，导致出现经典的三联征症状——肌肉疼痛、无力和茶色尿。据报道，脊柱手术后发生的横纹肌溶解症病例仅有少数。
病例描述
一名36岁男性因L4 - S1退行性脊柱病（DS）导致的顽固性下背痛和右下肢神经根病，接受了右侧微创经椎间孔腰椎椎体间融合术（miTLIF），手术过程顺利。术后，患者抱怨下肢疼痛顽固，药物治疗无效。随后他被诊断为横纹肌溶解症，积极的静脉补液复苏治疗使其完全康复。
结论
横纹肌溶解症应通过积极的静脉补液复苏进行及时诊断和治疗，以避免miTLIF手术后发生急性肾损伤。
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