Gomibuchi F
Department of Orthopaedic Surgery, Niigata University School of Medicine, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1988 Dec;62(12):1177-88.
Seventy-two cases of acute non-traumatic myelopathy in which walking became impossible within one week after the onset of paralysis were investigated. Fifty-one cases (71%) consisted of mass lesions requiring surgery, such as metastatic spine tumors, hemangioma of spinal cord and hematoma within the spinal canal. Others were 6 cases of anterior spinal artery syndrome and 15 cases of undetermined diagnosis. Pain preceding paralysis or paralysis itself was the initial symptom in 64% of the spinal metastases. Severe pain followed by rapidly progressive paralysis was associated with the vascular lesions. Myelography was generally the most useful diagnostic tool of mass lesions and angiography was also useful in vascular lesions. Walking ability was recovered in 23 of 47 cases after spinal decompression. Postoperative recovery was especially marked when operation was done in the stage of incomplete paralysis. Locating the mass lesion and timely decompression were the most important approaches for handling these conditions.
对72例急性非创伤性脊髓病患者进行了调查，这些患者在瘫痪发作后一周内无法行走。51例（71%）为需要手术的占位性病变，如脊柱转移瘤、脊髓血管瘤和椎管内血肿。其他包括6例脊髓前动脉综合征和15例诊断不明的病例。64%的脊柱转移瘤患者在瘫痪前或瘫痪本身出现疼痛作为初始症状。严重疼痛后迅速进展性瘫痪与血管病变有关。脊髓造影通常是占位性病变最有用的诊断工具，血管造影对血管病变也有用。47例患者中有23例在脊髓减压后恢复了行走能力。在不完全瘫痪阶段进行手术时，术后恢复尤为明显。定位占位性病变并及时减压是处理这些情况的最重要方法。
