胸椎慢性髓外造血背景下的急性脊髓压迫症
Acute spinal cord compression in the setting of chronic extramedullary hematopoiesis of the thoracic spine.
作者信息
Agaisse Ty, Thomson Cameron, Balmaceno-Criss Mariah, McCluskey Leland, Diebo Bassel G, Kuris Eren, Daniels Alan H
机构信息
Department of Orthopedic Surgery, Warren Alpert Medical School, Brown University, 1 Kettle Point Ave, East Providence, RI 02914, United States.
出版信息
N Am Spine Soc J. 2023 Aug 3;15:100260. doi: 10.1016/j.xnsj.2023.100260. eCollection 2023 Sep.
BACKGROUND
Though rare, pathologic extramedullary hematopoiesis (EMH) can occur in response to myeloproliferative disorders and may present as paravertebral masses.
CASE DESCRIPTION
We describe a 63-year-old female with unspecified thalassemia, hemochromatosis, and known asymptomatic extramedullary hematopoiesis of the thoracic spine who acutely developed severe spinal cord compression and a T9 vacuum phenomenon fracture 7 months after her initial diagnosis.
OUTCOME
The patient was treated with urgent decompression and T9 kyphoplasty, which resulted in complete resolution of her neurological deficits.
CONCLUSIONS
The timeline of symptomatology in the case suggests that asymptomatic patients with T-spine extramedullary hematopoiesis can develop progressive neurologic deterioration and atraumatic compression fractures culminating in acute spinal cord injury. While it may be appropriate to treat asymptomatic patients conservatively, surgical decompression must always remain a consideration.
背景
病理性髓外造血（EMH）虽罕见，但可因骨髓增殖性疾病而发生，且可能表现为椎旁肿块。
病例描述
我们报告一名63岁女性，患有未明确分型的地中海贫血、血色素沉着症，已知胸椎存在无症状髓外造血，在初次诊断7个月后急性发生严重脊髓压迫和T9椎体真空现象性骨折。
结果
患者接受了紧急减压和T9椎体后凸成形术治疗，神经功能缺损完全恢复。
结论
该病例的症状发生时间线表明，胸椎髓外造血的无症状患者可能会出现进行性神经功能恶化和无创伤性压缩性骨折，最终导致急性脊髓损伤。虽然对无症状患者进行保守治疗可能是合适的，但手术减压始终是一个需要考虑的选项。
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