D'Angiolillo Joseph C, Patel Nitesh V, Hernandez R Nick, Hanft Simon
Private practice, Somerset, New Jersey.
Department of Neurosurgery, Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey.
J Chiropr Med. 2021 Sep;20(3):170-175. doi: 10.1016/j.jcm.2022.01.004. Epub 2022 Apr 6.
The purpose of this case report is to describe the presentation of a patient with bilateral lumbar radiculopathy secondary to myxopapillary ependymoma.
A 45-year-old man presented to a chiropractic office for evaluation and treatment of chronic lower back pain with bilateral lower extremity radiation. The initial onset of pain was related to a lifting injury 6 years prior that never fully resolved. Over the year before presentation, the symptomatology intensified, as the patient's activities now included a 1.5-hour commute to and from work.
In the interim of waiting for the magnetic resonance imaging (MRI) to be performed, chiropractic manual therapy was initiated using the Cox technique. The patient had 7 treatments, in which lumbar spine pain was reduced from 7 out of 10 to 5 out of 10 on a numeric pain scale and leg pain was reduced from 7 out of 10 to 0 out of 10. The patient obtained an MRI with contrast, which demonstrated a mass at the conus medullaris. An immediate consultation was made with a neurosurgeon. Surgical resection revealed a myxopapillary ependymoma. He was then followed up with by the neurosurgeon at 3 months and 1 year, with sustained improvements and no further symptoms. After surgery, the patient did well without complications.
A patient with an intradural mass at the level of the conus medullaris presented for chiropractic care and responded positively to treatment but had an underlying condition that was corrected with surgery. For this patient, MRI assisted with evaluation and early diagnosis, and surgical resection facilitated a beneficial outcome.
本病例报告旨在描述一名因黏液乳头型室管膜瘤继发双侧腰椎神经根病患者的临床表现。
一名45岁男性前往整脊诊所，评估和治疗伴有双侧下肢放射性疼痛的慢性下背痛。疼痛最初发作与6年前的一次举重损伤有关，此后一直未完全缓解。在就诊前一年，随着患者现在上下班通勤时间长达1.5小时，症状加重。
在等待进行磁共振成像（MRI）检查期间，采用考克斯技术开始进行整脊手法治疗。患者接受了7次治疗，在此期间，腰椎疼痛在数字疼痛量表上从10分中的7分降至5分，腿痛从10分中的7分降至0分。患者进行了增强MRI检查，结果显示脊髓圆锥处有一个肿块。立即咨询了神经外科医生。手术切除显示为黏液乳头型室管膜瘤。随后，神经外科医生在3个月和1年时对其进行了随访，患者持续改善且未出现进一步症状。术后患者恢复良好，无并发症。
一名脊髓圆锥水平硬膜内肿块患者前来接受整脊治疗，对治疗反应良好，但存在需手术纠正的潜在疾病。对于该患者，MRI有助于评估和早期诊断，手术切除促成了良好的治疗结果。
