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硬膜外脊髓动静脉节段性综合征（科布综合征）致胸段脊髓病：一例报告并文献复习

Epidural Spinal Arteriovenous Metameric Syndrome (Cobb Syndrome) Causing Thoracic Myelopathy: A Case Report and Review of Literature.

作者信息

Varma Nikhil, Palliyil Nigil, Vellara Jim F, Karumathil Pullara Sreekumar, Krishnan Arjun

机构信息

Orthopedics Spine Surgery, Amrita Institute of Medical Sciences Cochin, Kochi, IND.

Radiology, Amrita Institute of Medical Sciences Cochin, Kochi, IND.

出版信息

Cureus. 2025 Jun 9;17(6):e85609. doi: 10.7759/cureus.85609. eCollection 2025 Jun.

DOI:10.7759/cureus.85609
PMID:40636639
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12239691/
Abstract

A 26-year-old lady, with a prior history of cutaneous lesions on her mid-back, presented with features of thoracic myelopathy with progressive lower limb weakness and gait imbalance of two months duration. The Magnetic Resonance Imaging (MRI) scan was suggestive of spinal arteriovenous metameric syndrome (SAMS) with an epidural lesion from D9-L1 compressing the spinal cord. Following pre-operative embolization, the patient underwent a decompressive laminectomy and excision of the epidural lesion, after which her symptoms improved significantly. She has been followed up for 18 months without any recurrence. Spinal arteriovenous malformation (AVM) with exclusively epidural presentation is an extremely rare type of spinal arteriovenous metameric syndrome (SAMS). Combined endovascular and surgical interventions are the treatment of choice for this condition.

摘要

一名26岁女性，既往中背部有皮肤病变史，出现胸段脊髓病症状，表现为进行性下肢无力和步态失衡，持续两个月。磁共振成像（MRI）扫描提示脊髓动静脉节段性综合征（SAMS），伴有D9-L1水平的硬膜外病变压迫脊髓。术前栓塞后，患者接受了减压性椎板切除术并切除硬膜外病变，术后症状明显改善。她已接受随访18个月，无任何复发。仅表现为硬膜外病变的脊髓动静脉畸形（AVM）是脊髓动静脉节段性综合征（SAMS）的一种极其罕见的类型。血管内和手术联合干预是治疗这种疾病的首选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/fad43db06351/cureus-0017-00000085609-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/543a299044ad/cureus-0017-00000085609-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/ab9f43ff2516/cureus-0017-00000085609-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/b5f5c7fa070b/cureus-0017-00000085609-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/511c488da692/cureus-0017-00000085609-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/b9cf15feba61/cureus-0017-00000085609-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/fad43db06351/cureus-0017-00000085609-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/543a299044ad/cureus-0017-00000085609-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/ab9f43ff2516/cureus-0017-00000085609-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/b5f5c7fa070b/cureus-0017-00000085609-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/511c488da692/cureus-0017-00000085609-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/b9cf15feba61/cureus-0017-00000085609-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b84/12239691/fad43db06351/cureus-0017-00000085609-i06.jpg

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本文引用的文献

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Extensive Spinal Hemangioma Associated With Cutaneous Nevus in the Same Metamere: An Unusual Case of Paraplegia in the Peripartum Period.同一节段广泛的脊髓血管瘤合并皮肤痣：围产期截瘫的罕见病例
Cureus. 2024 Feb 22;16(2):e54673. doi: 10.7759/cureus.54673. eCollection 2024 Feb.
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Report of a case of Cobb syndrome: multimodality imaging.Cobb综合征病例报告：多模态成像
BJR Case Rep. 2020 Oct 23;7(1):20200145. doi: 10.1259/bjrcr.20200145. eCollection 2021 Feb 1.
3
Cobb Syndrome Manifesting as Repetitive Seizures in a 10-Year-Old Girl: A Case Report and Literature Review.
以10岁女孩反复癫痫发作为表现的科布综合征：一例报告及文献复习
Front Neurol. 2019 Dec 6;10:1302. doi: 10.3389/fneur.2019.01302. eCollection 2019.
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Anesthetic Considerations in Cobb Syndrome: A Case Report.
A A Pract. 2019 Aug 15;13(4):137-139. doi: 10.1213/XAA.0000000000001016.
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Cobb syndrome: A rare cause of paraplegia.科布综合征：截瘫的罕见病因。
Ann Neurosci. 2015 Jul;22(3):191-3. doi: 10.5214/ans.0972.7531.220312.
6
Exclusively epidural spinal metameric arteriovenous shunts: case report and literature review.单纯硬膜外脊髓节段性动静脉分流术：病例报告及文献综述
Spine J. 2015 Mar 1;15(3):e15-22. doi: 10.1016/j.spinee.2014.11.022. Epub 2014 Nov 29.
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Spinal arteriovenous metameric syndrome: clinical manifestations and endovascular management.脊髓动静脉分节综合征：临床表现与血管内治疗。
AJNR Am J Neuroradiol. 2013 Feb;34(2):457-63. doi: 10.3174/ajnr.A3212. Epub 2012 Aug 2.
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Spinal arteriovenous malformation associated with spinal metameric syndrome: a treatable cause of long-term paraplegia?脊髓动静脉畸形伴脊髓体节综合征：一种可治疗的长期截瘫原因？
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J Neurointerv Surg. 2011 Sep;3(3):293-6. doi: 10.1136/jnis.2010.002972. Epub 2011 Apr 6.
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