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经皮椎体后凸成形术后复发性脊柱硬膜下血肿:一例独特病例报告。

Recurrent spinal subdural hematoma following percutaneous kyphoplasty: A unique case report.

机构信息

Department of Orthopedics, People's Hospital of Fujian Province, Fuzhou, 350000, China.

Department of Orthopedics, People's Hospital of Fujian Province, Fuzhou, 350000, China.

出版信息

Chin J Traumatol. 2024 Dec;27(6):354-358. doi: 10.1016/j.cjtee.2024.08.005. Epub 2024 Aug 17.

Abstract

Spinal intradural (subdural and subarachnoid) hematoma following percutaneous kyphoplasty is an extremely rare complication. In this report, we described a case of 2 episodes of subarachnoid hemorrhage with delayed paralysis after kyphoplasty. A 73-year-old man underwent percutaneous kyphoplasty in our hospital an osteoporotic vertebral fracture at the T12 level. On the 55 h after kyphoplasty for T12 osteoporotic vertebral fracture, he developed paralysis of the lower limbs. An emergency posterior decompression from T8 to L2 was performed. And the subarachnoid hematomas were removed. Postoperatively, the neurological symptoms improved rapidly. However, 2 weeks after the operation, the patient experienced a setback with severe neurological decline (paraplegia with sensory and autonomic dysfunction). An emergency posterior decompression from T5 to L2 was performed. The subarachnoid hematomas were removed. This case reflects the cause and progression of spinal subdural hematoma. Previous literature has debated the best treatment approach for spinal subarachnoid hemorrhage, but the prognosis of patients is heavily dependent on precise symptom evaluation and localization.

摘要

经皮椎体后凸成形术后椎管内(硬脊膜下和蛛网膜下腔)血肿是一种极罕见的并发症。本报告描述了 1 例经皮椎体后凸成形术后 2 次蛛网膜下腔出血伴迟发性瘫痪的病例。1 名 73 岁男性因 T12 骨质疏松性椎体骨折在我院行经皮椎体后凸成形术。在 T12 骨质疏松性椎体骨折行后凸成形术后第 55 小时,他出现下肢瘫痪。紧急行 T8 至 L2 的后路减压术,并清除了蛛网膜下腔血肿。术后,神经症状迅速改善。然而,术后 2 周,患者病情出现恶化,出现严重的神经功能下降(截瘫伴感觉和自主神经功能障碍)。紧急行 T5 至 L2 的后路减压术,并清除了蛛网膜下腔血肿。该病例反映了脊髓硬脊膜下血肿的病因和进展。既往文献对脊髓蛛网膜下腔出血的最佳治疗方法存在争议,但患者的预后严重依赖于精确的症状评估和定位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0697/11624302/3b0475cf28e8/gr1.jpg

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