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青少年因巨大中央型椎间盘突出症导致马尾综合征。一例病例报告。

Large central disc herniation causing cauda equina syndrome in an adolescent. A case report.

作者信息

Moussa Mohamad K, Alkefrawi Peggy, Elkhalil Joseph K

机构信息

The Department of Orthopedic Surgery at the Lebanese University, The Faculty of Medical Sciences, Hadath, Lebanon.

The Department of Pediatrics at the Lebanese University, The Faculty of Medical Sciences, Hadath, Lebanon.

出版信息

Int J Surg Case Rep. 2021 Feb;79:119-122. doi: 10.1016/j.ijscr.2020.12.066. Epub 2021 Jan 11.

Abstract

BACKGROUND

Cauda equina syndrome is a surgical emergency that requires early diagnosis and prompt intervention. It is a challenging diagnosis with a wide variety of clinical presentations that may delay the diagnosis and result in complications that severely affect the patient's quality of life.

CASE REPORT

We present a case of a 15-years-old child affected with acute cauda equina syndrome (CES) secondary to an acute disc herniation after lifting a heavy object. The patient was treated with decompressive laminectomy and discectomy that resulted in significant neurological improvement.

DISCUSSION

Etiologic factors of CES in the pediatric population include tumors, trauma, iatrogenic injuries, spinal dysraphism, constipation and inferior vena cava syndrome. This case is being reported for the rarity of this syndrome in pediatric population especially when the etiological factor is acute disc herniation, which is also rare in this particular population.

CONCLUSION

This report is thought to increase the index of suspicion of CES in this age group especially in the presence of inciting event allowing early diagnosis and better outcomes.

摘要

背景

马尾综合征是一种外科急症,需要早期诊断和及时干预。它是一个具有挑战性的诊断,临床表现多种多样,可能会延迟诊断并导致严重影响患者生活质量的并发症。

病例报告

我们报告一例15岁儿童,因重物搬运后急性椎间盘突出继发急性马尾综合征(CES)。患者接受了减压椎板切除术和椎间盘切除术,神经功能得到显著改善。

讨论

儿童人群中CES的病因包括肿瘤、创伤、医源性损伤、脊柱裂、便秘和下腔静脉综合征。报告该病例是因为这种综合征在儿童人群中罕见,尤其是当病因是急性椎间盘突出时,而急性椎间盘突出在该特定人群中也很少见。

结论

本报告旨在提高对该年龄组CES的怀疑指数,尤其是在存在诱发事件的情况下,以便早期诊断并获得更好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a0d/7815462/86604ea8c1ce/gr1.jpg

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