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减压手术后明显骨质过度生长导致的腰椎管狭窄

Lumbar Canal Stenosis Caused by Marked Bone Overgrowth after Decompression Surgery.

作者信息

Shimauchi-Ohtaki Hiroya, Minami Manabu, Takahashi Toshiyuki, Kanematsu Ryo, Honda Fumiaki, Hanakita Junya

机构信息

Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Shizuoka, Japan.

Department of Neurosurgery, Gunma University Graduate School of Medicine, Japan.

出版信息

Case Rep Orthop. 2022 Jun 3;2022:9462399. doi: 10.1155/2022/9462399. eCollection 2022.

Abstract

Narrowing of the lumbar canal due to bone regrowth after lumbar decompression surgery generally occurs at the facet joint; it is exceedingly rare for this phenomenon to occur at the laminar arch. Herein, we describe a case of restenosis caused by marked bone overgrowth at the facet joints and laminar arch after lumbar decompression surgery. A 64-year-old man underwent partial hemilaminectomy for lumbar canal stenosis at the L3/L4 level 12 years ago. His symptoms recurred 7 years after the first surgery. Overgrowth of the laminar arch and facet joints was observed at the decompression site. Thus, partial laminectomy of L3 and L4 was performed as a second surgery. Four years after the second surgery, a laminectomy of L3-L4 was performed for bone restenosis and disc herniation. The underlying mechanism of the remarkable overgrowth of the removed lamina remains unclear. Endochondral ossification signals and mechanosignals should be comprehensively examined.

摘要

腰椎减压手术后因骨再生导致的腰椎管狭窄通常发生在小关节;这种现象在椎板弓处发生极为罕见。在此,我们描述一例腰椎减压手术后小关节和椎板弓处明显骨过度生长导致再狭窄的病例。一名64岁男性12年前因L3/L4水平的腰椎管狭窄接受了部分半椎板切除术。首次手术后7年症状复发。在减压部位观察到椎板弓和小关节过度生长。因此,作为第二次手术进行了L3和L4的部分椎板切除术。第二次手术后4年,因骨再狭窄和椎间盘突出进行了L3-L4椎板切除术。切除椎板明显过度生长的潜在机制尚不清楚。应全面检查软骨内成骨信号和机械信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/337e/9187487/d76916fb6ec5/CRIOR2022-9462399.001.jpg

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本文引用的文献

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Mechanisms of bone development and repair.骨发育和修复的机制。
Nat Rev Mol Cell Biol. 2020 Nov;21(11):696-711. doi: 10.1038/s41580-020-00279-w. Epub 2020 Sep 8.
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Eur Spine J. 2003 Oct;12 Suppl 2(Suppl 2):S170-5. doi: 10.1007/s00586-003-0612-1. Epub 2003 Sep 9.
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Bone regrowth after surgical decompression for lumbar spinal stenosis.腰椎管狭窄症手术减压后的骨再生
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