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仅表现为腹痛并伴有胸神经根病的胸椎间盘突出症

Thoracic Disc Herniation Manifesting as Abdominal Pain Alone Associated with Thoracic Radiculopathy.

作者信息

Ishii Motonori, Nishimura Yusuke, Hara Masahito, Eguchi Kaoru, Nagashima Yoshitaka, Awaya Takayuki, Ando Ryo, Haimoto Shoichi, Wakabayashi Toshihiko

机构信息

Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan.

Department of Neurosurgery, Aichi Medical University, Nagakute, Aichi, Japan.

出版信息

NMC Case Rep J. 2020 Sep 15;7(4):161-165. doi: 10.2176/nmccrj.cr.2019-0247. eCollection 2020 Sep.

Abstract

Symptomatic thoracic disc herniation (TDH) with thoracic radiculopathy alone is an extremely rare condition. Here, we report a rare case of TDH in a 52-year-old man who presented with medically refractory severe right flank pain. Based on pain distribution, pain intensity changes according to truncal position, ineffectiveness of intercostal nerve block, and radiological findings, his pain was determined to be caused by TDH at T9-10 level. Symptomatic TDH often requires invasive surgery. However, TDH with radiculopathy alone can be treated via a posterior approach without spinal cord manipulation or spinal fusion. We could eliminate the pain by removing TDH with hemilaminectomy and microdiscectomy using an O-arm-based navigation system.

摘要

单纯有胸神经根病症状的胸椎间盘突出症(TDH)极为罕见。在此,我们报告一例罕见的52岁男性TDH病例,该患者表现为药物治疗无效的严重右侧胁腹疼痛。根据疼痛分布、疼痛强度随躯干位置的变化、肋间神经阻滞无效以及影像学检查结果,确定其疼痛由T9 - 10节段的TDH引起。有症状的TDH通常需要进行侵入性手术。然而,单纯有神经根病的TDH可通过后路手术治疗,无需脊髓操作或脊柱融合。我们使用基于O型臂的导航系统,通过半椎板切除术和显微椎间盘切除术切除TDH,从而消除了疼痛。

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