Yunde Atsushi, Maki Satoshi, Furuya Takeo, Ikeda Jun-Ichiro, Ohtori Seiji
Department of Orthopaedic Surgery, Chiba University, Graduate School of Medicine, Chiba, JPN.
Department of Diagnostic Pathology, Chiba University, Graduate School of Medicine, Chiba, JPN.
Cureus. 2023 Sep 11;15(9):e45017. doi: 10.7759/cureus.45017. eCollection 2023 Sep.
Intradural extramedullary tuberculomas are a rare manifestation of tuberculosis that can lead to neurological deficits. We present a case of a 26-year-old male from Myanmar with lower limb weakness and gait disturbance, who was diagnosed with tuberculosis and found to have an intradural extramedullary lesion in the thoracic spine. Prompt surgical intervention was performed to address the lesion located at the T2-4 level. Although complete resection was hindered by strong adhesion, significant improvement in lower limb paralysis was achieved. The elasticity loss of the dura mater posed a challenge in suturing, necessitating duraplasty with a synthetic graft material. This case report emphasizes the potential significance of surgical intervention, including partial excision, in the management of intradural extramedullary tuberculomas. Surgical treatment can play a crucial role in improving neurological outcomes in patients with intradural extramedullary tuberculomas, even in challenging scenarios.
硬脊膜内髓外结核瘤是结核病的一种罕见表现，可导致神经功能缺损。我们报告一例来自缅甸的26岁男性，有下肢无力和步态障碍，被诊断为结核病，发现胸椎有硬脊膜内髓外病变。对位于T2-4水平的病变进行了及时的手术干预。尽管由于粘连严重阻碍了完整切除，但下肢瘫痪仍有显著改善。硬脊膜弹性丧失给缝合带来了挑战，需要用合成移植材料进行硬脊膜成形术。本病例报告强调了手术干预（包括部分切除）在硬脊膜内髓外结核瘤治疗中的潜在重要性。手术治疗在改善硬脊膜内髓外结核瘤患者的神经功能结局方面可发挥关键作用，即使在具有挑战性的情况下也是如此。
