伪装成背痛的孤立性骨浆细胞瘤压迫损伤：一例报告
Solitary bone plasmacytoma compression injury disguised as back pain: a case report.
作者信息
Jackson Steven D, Wiering Bethany A, Herrmann Amanda A, Hinz MacKenna A, Hanson Leah R
机构信息
HealthPartners Neuroscience Center, St. Paul, MN, USA.
Regions Hospital, St. Paul, MN, USA.
出版信息
Spinal Cord Ser Cases. 2019 Feb 11;5:16. doi: 10.1038/s41394-019-0161-4. eCollection 2019.
INTRODUCTION
Low back pain is a leading disability worldwide; however, it is not often the result of a serious underlying condition such as a tumor. As a result, diagnosis of a serious underlying cause of low back pain may be delayed, such as in this case.
CASE PRESENTATION
We describe a case of a man presenting with low back pain, who was eventually diagnosed with solitary bone plasmacytoma (SBP) causing spinal cord compression from approximately T7-T9. The patient was classified as T8 ASIA C-Incomplete Paraplegia. He underwent an emergency T7-T9 open posterior laminectomy and resection of the epidural mass/tumor. Following an intensive course of rehabilitation treatment, the patient progressed to ASIA D.
DISCUSSION
Although SBP of the spine is rare, back or neck pain is a common initial presentation. This case is unique in that we provide a detailed description of both medical and rehabilitation diagnosis and treatment. We also suggest that persistent back pain warrants complete MRI spinal imaging to provide proper diagnosis and prompt treatment for cases with a serious underlying condition.
引言
腰痛是全球导致残疾的主要原因之一；然而，它并不常由诸如肿瘤等严重潜在疾病引起。因此，如本病例所示，对腰痛严重潜在病因的诊断可能会延迟。
病例介绍
我们描述了一例以腰痛就诊的男性病例，该患者最终被诊断为孤立性骨浆细胞瘤（SBP），导致脊髓从大约T7 - T9节段受压。患者被分类为T8 ASIA C级不完全性截瘫。他接受了紧急的T7 - T9后路开放性椎板切除术及硬膜外肿块/肿瘤切除术。经过强化康复治疗后，患者恢复至ASIA D级。
讨论
尽管脊柱SBP罕见，但背部或颈部疼痛是常见的初始表现。本病例的独特之处在于我们提供了医学及康复诊断与治疗的详细描述。我们还建议，对于持续的背痛，应进行完整的脊柱MRI成像，以便对存在严重潜在疾病的病例进行正确诊断并及时治疗。
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