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脊柱翻修融合术后作为并发症的脊髓硬膜下积液：一例报告

Spinal subdural hygroma as a post-operative complication in revision spine fusion: a case report.

作者信息

Nentwig Michelle J, Whitaker Camden M, Yang Shang-You

机构信息

Department of Orthopaedics Surgery, University of Kansas School of Medicine-Wichita, 929 N. Saint Francis, Wichita, KS 67214, USA.

Orthopaedic Sports Medicine at Cypress, 10100 East Shannon Woods Circle, Suite 100 Wichita, KS 67226, USA.

出版信息

J Surg Case Rep. 2019 Nov 6;2019(11):rjz305. doi: 10.1093/jscr/rjz305. eCollection 2019 Nov.

DOI:10.1093/jscr/rjz305
PMID:31723404
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6831950/
Abstract

Lumbar spine fusion has become a common and effective procedure in orthopedic practice, and a spinal subdural hygroma development is a rare complication following this procedure. We report here the case of a revision lumbar spine fusion at levels L4-5, L5-S1, where the patient subsequently developed cauda equina syndrome 2 days post-operatively. Magnetic resonance imaging (MRI) showed a subdural, extra-arachnoid fluid collection from T12-L2, cephalad to the site of spine fusion. It appears the first case reported a subdural hygroma developed cephalad to the site of spine fusion. When a patient complains of radicular pain along with urinary retention and neurologic deficits post-lumbar spine surgery, cauda equina syndrome possibly caused by subdural hygroma should be considered. This warrants immediate MRI and emergent reoperation to relieve the pressure on the spinal cord may be necessary.

摘要

腰椎融合术已成为骨科临床中一种常见且有效的手术，而脊柱硬膜下积液是该手术后罕见的并发症。我们在此报告一例L4 - 5、L5 - S1节段的翻修腰椎融合术病例，该患者术后2天出现马尾综合征。磁共振成像（MRI）显示从T12 - L2有硬膜下、蛛网膜外积液，位于脊柱融合部位头侧。这似乎是首例报道的在脊柱融合部位头侧发生硬膜下积液的病例。当腰椎手术后患者出现神经根性疼痛并伴有尿潴留和神经功能缺损时，应考虑可能由硬膜下积液引起的马尾综合征。这需要立即进行MRI检查，可能有必要紧急再次手术以减轻脊髓压力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c114/6831950/c8fe3b5ef69b/rjz305f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c114/6831950/439618d8721d/rjz305f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c114/6831950/c8fe3b5ef69b/rjz305f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c114/6831950/439618d8721d/rjz305f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c114/6831950/c8fe3b5ef69b/rjz305f2.jpg

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