Yalçın Demirci Adnan Yalçın, Yiğitkanlı Kazım
Neurosurgery Clinic, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
Neurosurgery Clinic, Medicana Bursa Hospital, Bursa, Turkey.
Acta Orthop Traumatol Turc. 2023 Mar;57(2):85-88. doi: 10.5152/j.aott.2023.21083.
Cervical myelopathy is a condition that is rarely reported in pediatric patients who have movement or neuromuscular disorders. We, herein, present a rare case of cervical myelopathy observed in a 14-year-old patient, who was previously a healthy boy treated with cervical laminoplasty, which was caused by cervical spinal canal stenosis based on multiple level disc herniation. The patient presented to the clinic with spastic and ataxic gait with previous diagnostic challenges. Magnetic resonance imaging showed cervical degenerative changes mainly marked at the C3-C4 and C4-C5 levels, along with canal narrowing and a central high signal cord abnormality on T2-weighted images. A C3-C4 open-door laminoplasty surgery technique was performed. The neurological symptoms and signs improved dramatically following surgery. Subsequently, cervical computed tomography and magnetic resonance imaging showed good decompression of the cervical spinal cord during the 5 years of follow-up with the preservation of the range of movement. We concluded that though it is pretty rare, cervical myelopathy should be considered in diagnosing adolescent patients with gait and balance disorders.
颈椎脊髓病在患有运动或神经肌肉疾病的儿科患者中很少见。在此，我们报告一例罕见的颈椎脊髓病病例，患者为一名14岁男孩，此前身体健康，因多节段椎间盘突出导致颈椎管狭窄而接受颈椎椎板成形术。该患者因痉挛性共济失调步态就诊，此前诊断存在挑战。磁共振成像显示颈椎退变主要集中在C3 - C4和C4 - C5水平，伴有椎管狭窄以及T2加权图像上脊髓中央高信号异常。实施了C3 - C4开门式椎板成形术。术后神经症状和体征显著改善。随后，颈椎计算机断层扫描和磁共振成像显示，在5年的随访中，颈椎脊髓得到了良好的减压，且活动范围得以保留。我们得出结论，尽管颈椎脊髓病相当罕见，但在诊断患有步态和平衡障碍的青少年患者时应予以考虑。
