Han Xiao, Xu Derong, Ren ZhiNan, Chen Xin, Li Zheng, Li Shugang
Department of Orthopaedics, Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking UnionDongcheng District Shuaifuyuan No. 1, Beijing, 100730, China.
Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China.
BMC Surg. 2021 Apr 26;21(1):215. doi: 10.1186/s12893-021-01157-8.
Spinal epidural lipomatosis is a rare cause of lumbar spinal stenosis. While conservative therapy is applicable for most of cases, surgical intervention is necessary for severe ones. This is the first time we apply this modified technique to this disease.
The case is a 53-year-old man. He is 175 cm tall and weighs 102 kg (body mass index 33.3 kg/cm), presenting with low back pain and bilateral legs pain and numbness. Radiological examination showed severe lumbar spinal stenosis resulting from adipose hyperplasia, combined with hyperosteogeny and hypertrophy of ligaments, which are common etiological factors. Posterior decompression, internal fixation and a modified articular fusion technique was performed on this patient, and regular follow-up that up o 22 months showed outstanding clinical outcomes.
A suitable style of posterior lumbar fusion should be considered to especially severe case with lumbar spinal stenosis and idiopathic spinal epidural lipomatosis.
脊髓硬膜外脂肪增多症是腰椎管狭窄症的罕见病因。虽然大多数病例适用保守治疗，但严重病例则需要手术干预。这是我们首次将这种改良技术应用于该疾病。
该病例为一名53岁男性。他身高175厘米，体重102千克（体重指数33.3千克/平方厘米），表现为腰痛及双侧腿部疼痛和麻木。影像学检查显示，由脂肪增生导致的严重腰椎管狭窄，合并骨质增生和韧带肥厚，这些都是常见的病因。对该患者实施了后路减压、内固定及改良关节融合技术，长达22个月的定期随访显示出优异的临床效果。
对于伴有腰椎管狭窄和特发性脊髓硬膜外脂肪增多症的严重病例，应考虑采用合适的后路腰椎融合方式。
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