Bruns J, Rehder U, Dahmen G P, Behrens P, Meiss L
Department of Orthopaedic Surgery, University of Hamburg, Germany.
Eur Spine J. 1994;3(5):265-9. doi: 10.1007/BF02226577.
We report on a rare disease called to Anquin's disease or spinous engagement or impingement syndrome. Low-back pain in this specific syndrome probably combined with sciatica is caused by a hypertrophic spinous process along with a spina bifida occulta of the underlying vertebra. Mostly, the enlarged spinous process is seen at L5 and the spina bifida occulta at S1. Conservative therapy consists of physiotherapy with postural exercises including improvement of lumbar flexion. If conservative treatment is unsuccessful, surgical treatment is indicated. Surgical therapy should include resection of the hypertrophic spinous process, probably combined with revision of the nerve roots and division of adhesions. Between 1981 and 1993 six patients were treated surgically after long-lasting periods of conservative therapy. All patients were re-examined clinically and radiologically after a mean follow-up period of 2.9 years. In all but one patient a distinct release from lumbar back pain and/or sciatica was observed. Regarding this, the most important fact in de Anquin's disease is to be aware of this specific syndrome. If low-back pain can be traced to a hypertrophic spinous process the first choice of therapy should be conservative. In unsuccessful cases simple surgical resection probably combined with division of the adhesion can lead to significant release from pain and is recommended.
我们报告了一种罕见疾病，称为安坎氏病或棘突嵌顿或撞击综合征。这种特定综合征中的下背痛可能伴有坐骨神经痛，是由肥大的棘突以及其下方椎体的隐性脊柱裂引起的。大多数情况下，增大的棘突见于L5，隐性脊柱裂见于S1。保守治疗包括物理治疗及姿势锻炼，包括改善腰椎前屈。如果保守治疗不成功，则需进行手术治疗。手术治疗应包括切除肥大的棘突，可能还需同时修复神经根并松解粘连。1981年至1993年间，6例患者在经过长期保守治疗后接受了手术治疗。所有患者在平均随访2.9年后均接受了临床和影像学复查。除1例患者外，其他所有患者的下背痛和/或坐骨神经痛均有明显缓解。就此而言，安坎氏病最重要的是要认识到这种特定综合征。如果下背痛可追溯至肥大的棘突，首选治疗应为保守治疗。在治疗失败的病例中，简单的手术切除可能还需同时松解粘连，可显著缓解疼痛，值得推荐。
