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一名因脊髓肿瘤导致脊髓疾病的孕妇的诊断与康复

Diagnosis and rehabilitation of a pregnant woman with spinal cord disorder due to spinal cord tumor.

作者信息

Bitterman Jason, Donovan Jayne, Lam Mylan

机构信息

1Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ USA.

2Kessler Institute for Rehabilitation, West Orange, NJ USA.

出版信息

Spinal Cord Ser Cases. 2019 Jan 24;5:8. doi: 10.1038/s41394-019-0153-4. eCollection 2019.

Abstract

INTRODUCTION

Spinal cord tumors are a rare cause of spinal cord disorder (SCD). Early diagnosis can be challenging, especially in patient populations with other potential etiologies for back pain, such as pregnant women.

CASE PRESENTATION

A 28-year-old female presented at 8 weeks gestation with thoracic back pain initially diagnosed as gestational low back pain. Her symptoms progressed to lower extremity weakness. After diagnosis and resection of a spinal cord ependymoma, we collaborated with the inpatient interdisciplinary team to devise a rehabilitation program focused on minimizing pregnancy-related complications and optimizing care of a newborn in the setting of a new paraplegia.

DISCUSSION

Providers should not assume all pregnant women with low back pain have gestational back pain, as it can be due to more insidious causes. The rehabilitation course for women who develop an SCD during gestation should be carefully tailored toward their pre- and post-natal care and with the education of how the disorder can affect pregnancy and parenting.

摘要

引言

脊髓肿瘤是脊髓疾病(SCD)的罕见病因。早期诊断可能具有挑战性,尤其是在有其他潜在背痛病因的患者群体中,如孕妇。

病例介绍

一名28岁女性在妊娠8周时出现胸背部疼痛,最初被诊断为妊娠期腰痛。她的症状发展为下肢无力。在诊断并切除脊髓室管膜瘤后,我们与住院多学科团队合作,制定了一个康复计划,重点是尽量减少与妊娠相关的并发症,并在新截瘫的情况下优化对新生儿的护理。

讨论

医疗服务提供者不应假定所有有腰痛的孕妇都患有妊娠期腰痛,因为它可能是由更隐匿的原因引起的。对于在妊娠期发生SCD的女性,康复过程应根据她们的产前和产后护理情况,并结合该疾病如何影响妊娠和育儿的教育进行精心调整。

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