腰椎浆细胞瘤继发截瘫
Paraplegia Secondary to Plasmacytoma of the Lumbar Spine.
作者信息
Eseonu K C, Middleton S D, Subramanian A S
机构信息
Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
Department of Orthopaedic Spinal Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland.
出版信息
Int J Spine Surg. 2020 Aug;14(4):559-562. doi: 10.14444/7074. Epub 2020 Jul 31.
BACKGROUND
Solitary plasmacytoma of bone has a predilection for the axial skeleton, most commonly affecting the thoracic spine. We report the case of a patient who presented with acute on chronic back pain and developed severe neurologic deficits within several hours of admission secondary to a pathologic fracture of L1.
METHODS
The patient underwent an urgent magnetic resonance imaging scan followed by T12 to L2 posterior decompression and T11 to L3 posterior instrumented stabilization. Subsequent histopathologic examination of specimens taken at the time of surgery found this to be secondary to a plasmacytoma affecting the lumbar spine.
RESULTS
At follow-up, recovery has been rapid and extensive, with the patient remaining under hematologic review because of the risk for developing multiple myeloma.
CONCLUSIONS
The unique features of this case relate to the location of the plasmacytoma and the neurologic signs; to our knowledge this is the first reported case in the literature of paraplegia secondary to a lumbar spine plasmacytoma.
背景
骨孤立性浆细胞瘤好发于中轴骨骼，最常累及胸椎。我们报告一例患者，该患者以慢性背痛急性发作为表现，入院数小时内继发L1病理性骨折后出现严重神经功能缺损。
方法
患者接受了紧急磁共振成像扫描，随后进行了T12至L2后路减压以及T11至L3后路器械固定。手术时获取的标本随后进行的组织病理学检查发现这是由累及腰椎的浆细胞瘤继发所致。
结果
随访时，恢复迅速且广泛，由于存在发展为多发性骨髓瘤的风险，患者仍在接受血液学检查。
结论
该病例的独特之处与浆细胞瘤的位置和神经体征有关；据我们所知，这是文献中首例报告的继发于腰椎浆细胞瘤的截瘫病例。
Zotero 插件