Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
World Neurosurg. 2023 Dec;180:10-12. doi: 10.1016/j.wneu.2023.09.016. Epub 2023 Sep 7.
Systemic sclerosis affects 14-21 per million persons annually and can present with calcinosis-deposition in the skin and subcutaneous tissues. In rare circumstances, paraspinal depositions are also seen, which can cause neural element compression requiring surgical intervention. Here we present the case of a 61-year-old woman with systemic sclerosis on goal-directed therapy who presented with neurogenic pseudoclaudication and imaging suggesting severe joint hypertrophy. The case illustrates that calcinosis in scleroderma can cause facet joint pseudohypertrophy that is difficult to distinguish from true hypertrophy on imaging. Such pseudohypertrophy is often refractory to medical therapy, necessitating surgical intervention. Last, owing to the fluid nature of the calcinotic fluid, decompression is often easier than would be expected based on preoperative imaging alone.
系统性硬化症每年影响 14-21/100 万人，可表现为皮肤和皮下组织的钙沉积。在罕见的情况下，也可见到椎旁沉积，可导致需要手术干预的神经元素受压。本文介绍了一位 61 岁的女性系统性硬化症患者，她接受了靶向治疗，表现为神经性假性跛行，影像学提示严重的关节肥大。该病例表明，硬皮病中的钙沉积可导致小关节假性肥大，在影像学上难以与真正的肥大相区分。这种假性肥大通常对药物治疗有抗性，需要手术干预。最后，由于钙沉积的液体性质，减压通常比仅根据术前影像学预期的要容易。
