Department of Surgical and Perioperative Sciences, Umeå University, Orthopaedics, Umeå, Sweden.
Division of Neuroradiology, Umeå University, Umeå, Sweden.
Acta Neurochir (Wien). 2024 Feb 10;166(1):75. doi: 10.1007/s00701-024-05982-7.
Hirayama's disease (HD) is most common in young males, and previous studies are predominantly from Asian countries. The cause of HD is unknown but the most common theory about the pathology speculates on forward bending that causes a compression of the dura mater and the anterior horn of the spinal cord against the vertebra during an overstretch flexion that may result in myelopathy. Both anterior and posterior cervical surgical approaches have been shown to be effective in stopping the disease and improving function; however, HD is also reported to be a self-limited disease, and treatment with a cervical collar may be an alternative for these patients.
We report HD in a 17-year-old male from Sweden who underwent surgical treatment with a 2 level anterior cervical discectomy and fusion (ACDF) due to neurological progression from HD after conservative treatment.
HD is rare and is easily overlooked. Surgical intervention shows promising results for neurological progression, but HD is also reported to be a self-limited disease.
平山病（HD）最常见于年轻男性，以往的研究主要来自亚洲国家。HD 的病因不明，但最常见的病理理论推测是向前弯曲导致硬脑膜和脊髓前角在过度伸展弯曲时被压缩在脊椎上，可能导致脊髓病。前后颈椎手术入路均已被证明可有效阻止疾病进展并改善功能；然而，HD 也被报道为一种自限性疾病，对于这些患者，颈托治疗可能是一种替代方法。
我们报告了一例来自瑞典的 17 岁男性 HD 病例，该患者在保守治疗后因 HD 出现神经进展而行 2 节段前路颈椎间盘切除术和融合术（ACDF）。
HD 较为罕见，容易被忽视。手术干预对神经进展显示出有前景的结果，但 HD 也被报道为一种自限性疾病。
