医源性背侧脊髓脊膜膨出及夹式扩张硬脊膜修补术治疗 1 例报告。
Iatrogenic dorsal spinal cord herniation and repair with clip-based expansile duraplasty: a case report.
机构信息
Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, London, UK.
University College London (UCL) Medical School, London, UK.
出版信息
Spinal Cord Ser Cases. 2022 Mar 28;8(1):36. doi: 10.1038/s41394-022-00505-x.
INTRODUCTION
Myelopathy arising due to dorsal herniation of the spinal cord is a rare phenomenon, particularly so in the thoracic region. Where cases of thoracic dorsal cord herniation have been reported, the aetiology has typically been non-iatrogenic.
CASE PRESENTATION
We report the case of a paediatric oncology patient who presented with neurological deterioration secondary to thoracic dorsal spinal cord herniation, manifesting three months after laminectomy for biopsy of a spinal medulloblastoma lesion. We repaired the dural defect using non-penetrating titanium clips to create a secure expansile duraplasty, resulting in radiologically evident reduction of the cord herniation as well as corresponding clinical improvement.
DISCUSSION
Thoracic dorsal spinal cord herniation is an extremely rare occurrence after spinal surgery. Non-penetrating titanium clips can be used to form a secure expansile duraplasty following reduction of the cord herniation. Successful repair of the dural defect re-anteriorises the cord and can confer neurological benefit.
介绍
因脊髓背侧疝引起的脊髓病是一种罕见的现象，尤其是在胸段。虽然已经报道了胸段背侧脊髓疝的病例，但病因通常是非医源性的。
病例介绍
我们报告了一例儿科肿瘤患者的病例，该患者因胸段脊髓背侧疝导致神经功能恶化，在脊髓髓母细胞瘤病变活检行椎板切除术三个月后出现该症状。我们使用非穿透性钛夹修复硬脑膜缺损，以形成安全的扩张硬脑膜成形术，这导致了影像学上明显的脊髓疝复位，以及相应的临床改善。
讨论
胸段脊髓背侧疝在脊柱手术后极为罕见。在脊髓疝复位后，非穿透性钛夹可用于形成安全的扩张硬脑膜成形术。硬脑膜缺损的成功修复可使脊髓重新向前移位，并带来神经获益。
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