Medical School, Burrell College of Osteopathic Medicine, Las Cruces, New Mexico, USA
UNM Hospital, Albuquerque, New Mexico, USA.
BMJ Case Rep. 2024 Oct 30;17(10):e260850. doi: 10.1136/bcr-2024-260850.
We present a man in his 60s with a dorsal thoracic arachnoid web spanning levels T6-T8. The patient presented with gait abnormalities, severe neuropathic lower back pain and mild urinary incontinence without sensory deficits. He underwent laminectomy with arachnoid web fenestration. At the 6-week postoperative follow-up appointment, he had increased muscle strength in his lower extremities and was able to walk without shuffling his feet, with a straight back and standing upright. This is a marked improvement from his previous hunched and shuffling gait. He has had partial resolution of his neuropathic low back pain. Arachnoid webs are often confused with other neurological disorders, most commonly idiopathic ventral cord herniation, which prolongs the time to surgical intervention. Eventual fenestration of our patient's web led to significant improvement in gait and partial relief of his neuropathic low back pain.
我们报告一例 60 多岁男性患者，其胸背部蛛网膜有一横跨 T6-T8 水平的蛛网膜炎。患者表现为步态异常、严重的神经性下腰痛和轻度尿失禁，但无感觉缺失。他接受了椎板切除术和蛛网膜网孔开窗术。在术后 6 周的随访中，他下肢肌力增强，能够行走而不再拖着脚走，背部挺直，站立姿势端正。与之前弯腰拖着脚走的步态相比，这是明显的改善。他的神经性下腰痛也部分缓解。蛛网膜网通常与其他神经系统疾病混淆，最常见的是特发性腹侧脊髓疝，这会延长手术干预的时间。我们患者的蛛网膜网孔最终开窗导致其步态显著改善，神经性下腰痛部分缓解。
