University of Connecticut School of Medicine, UConn Health Center, 263 Farmington Ave, Farmington, CT, 06030, USA.
University of Connecticut, Storrs, CT, USA.
J Med Case Rep. 2024 Feb 4;18(1):42. doi: 10.1186/s13256-024-04367-9.
Many patients with transverse myelitis suffer from sensory loss below the spinal level of the lesion. This is commonly associated with chronic neuropathic pain. However, the presence of somatic pain below a complete thoracic sensory level after transverse myelitis is exceptionally rare, and it is unclear if surgical decompression is an effective form of treatment for these patients.
In this report, we describe a 22-year-old Caucasian female who suffered from chronic lumbar back pain despite a complete thoracic sensory level secondary to prior transverse myelitis. Imaging demonstrated multilevel central stenosis below the sensory level, and her pain improved after surgical decompression. To our knowledge, this is the first reported case of symptomatic lumbar stenosis below a sensory level after transverse myelitis successfully treated with surgical decompression.
This is the first reported case of a patient with symptomatic lumbar stenosis after transverse myelitis whose lower back pain and quality of life improved following surgical decompression and fusion. This case provides evidence that typical lumbago is possible in patients with sensory loss from transverse myelitis, and standard lumbar decompression may provide benefit for these patients.
许多横贯性脊髓炎患者在脊髓损伤水平以下会出现感觉丧失。这通常与慢性神经性疼痛有关。然而，横贯性脊髓炎后完全胸段感觉水平以下出现躯体疼痛极为罕见，且手术减压是否对这些患者有效尚不清楚。
本报告描述了一名 22 岁白人女性，曾患有横贯性脊髓炎，导致完全胸段感觉丧失，同时伴有慢性腰痛。影像学显示感觉水平以下的多个节段性中央狭窄，手术减压后其疼痛得到缓解。据我们所知，这是首例报道的经手术减压成功治疗的横贯性脊髓炎后感觉水平以下症状性腰椎狭窄症病例。
这是首例报道的横贯性脊髓炎后出现症状性腰椎狭窄症的患者，手术减压和融合后其腰痛和生活质量得到改善。该病例表明，横贯性脊髓炎导致感觉丧失的患者可能会出现典型腰痛，标准的腰椎减压可能对这些患者有益。
