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轻微创伤后突发四肢瘫痪。既往存在的脊柱管狭窄的作用。

Sudden quadriplegia after a minor trauma. The role of preexisting spinal stenosis.

作者信息

Firooznia H, Ahn J H, Rafii M, Ragnarsson K T

出版信息

Surg Neurol. 1985 Feb;23(2):165-8. doi: 10.1016/0090-3019(85)90337-4.

Abstract

Three patients are described who became quadriplegic after a minor trauma to the spine without suffering a spinal fracture dislocation. Radiologic investigation revealed marked stenosis of the spinal canal, due to developmental stenosis with superimposed degenerative changes in two patients, and calcification of posterior longitudinal ligament of the spine in one. Two patients recovered almost completely with conservative measures. The spinal cord may be able to tolerate slowly increasing mechanical pressure for many years and conform to the shape of the spinal canal without causing any neurological symptoms. However, when stenosis is severe, any additional pressure, for example, swelling and edema from trauma, may cause a neurologic catastrophe.

摘要

本文描述了3例患者,他们在脊柱受到轻微创伤后出现四肢瘫痪,但未发生脊柱骨折脱位。影像学检查显示椎管明显狭窄,其中2例是由于发育性狭窄叠加退行性改变,1例是由于脊柱后纵韧带钙化。2例患者通过保守治疗几乎完全康复。脊髓可能多年来能够耐受逐渐增加的机械压力,并适应椎管的形状而不引起任何神经症状。然而,当狭窄严重时,任何额外的压力,例如创伤引起的肿胀和水肿,都可能导致神经灾难。

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