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腰椎硬脊膜内椎间盘疝:病例报告及文献复习。

Lumbar Intradural Disc Herniation Caused by Injury: A Case Report and Literature Review.

机构信息

Department of Orthopaedics, the Second Hospital of Shanxi Medical University, NO.382, Wuyi Road, Taiyuan, 030001, Shanxi, China.

出版信息

Orthop Surg. 2023 Jun;15(6):1694-1701. doi: 10.1111/os.13723. Epub 2023 Apr 18.

Abstract

BACKGROUND

Intradural disc herniation(IDH) caused by trauma is a rare type of disease,which is difficult to diagnose clinically and is easily misdiagnosed. We received a patient with the disease, reported the case to share the process of diagnosis and treatment and put forward our own opinions, so as to increase the probability of correct diagnosis.

CASE PRESENTATION

We report the case of a 48-year-old male who fell from a scaffold at a height of 2 m. Later, he developed low back pain, restricted movement, numbness and hyperalgesia of the lower left limb, and decreased left muscle strength. He was diagnosed with IDH. Treatment with posterior decompression and intramedullary decompression with pedicle screw internal fixation was performed. His postoperative course was uneventful, and he underwent regular follow up for 1 year. Good neurologic symptom improvement was achieved.

CONCLUSIONS

IDH is rare, and comprehensive consideration and film reading can improve the correct diagnosis rate. Accurate diagnosis and early decompression of laminae and intramedullary decompression can lead to good recovery after neurologic impingement.

摘要

背景

创伤引起的硬脊膜内椎间盘突出症(IDH)是一种罕见的疾病,临床上难以诊断,容易误诊。我们收治了 1 例该病患者,报告病例旨在分享诊治过程并提出我们的观点,以提高正确诊断的概率。

病例介绍

我们报告了 1 例 48 岁男性患者,该患者从 2 m 高的脚手架上坠落。之后,他出现了腰痛、活动受限、左下肢麻木和痛觉过敏,左侧肌力下降。他被诊断为 IDH。行后路减压并通过椎弓根螺钉内固定进行髓内减压。他的术后过程顺利,定期随访 1 年。获得了良好的神经症状改善。

结论

IDH 罕见,综合考虑和读片可以提高正确诊断率。准确诊断和及时进行椎板及髓内减压可以在神经受压后获得良好的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f1/10235178/5c6f89b2a9e1/OS-15-1694-g008.jpg

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