Chang Y S, Ku M C, Lee T S
Department of Orthopaedic Surgery, Taichung Veterans General Hospital.
Zhonghua Yi Xue Za Zhi (Taipei). 1993 Jan;51(1):85-90.
Amyloidosis involving the musculoskeletal system is an uncommon occurrence. The primary form is rare and only six cases involving the spine have been reported in the literature. The following case is believed to be the first reported in Taiwan. A 65-year-old male was admitted due to chronic nonspecific pain in the lower back with progressive paralysis of the lower limbs. Amyloidoma involving both thoracic and lumbar spine, never reported in the literature, was proved by histologic and histochemical studies. Serial radiographic examinations were also presented. Anterior decompression of the thoracic spine with iliac crest strut bone graft and Kaneda device fixation achieved good functional results. The symptoms and signs of spinal amyloidoma are nonspecific and difficult to diagnose; hence a correct diagnosis requires the surgeon to be extremely suspicious. A special histochemical stain is essential for this purpose. Because of the rarity, we report this case with review of the literature.
累及肌肉骨骼系统的淀粉样变性并不常见。原发性形式罕见，文献中仅报道过6例累及脊柱的病例。以下病例据信是台湾地区首次报道。一名65岁男性因下背部慢性非特异性疼痛伴下肢进行性麻痹入院。经组织学和组织化学研究证实为累及胸椎和腰椎的淀粉样瘤，此前文献中从未报道过。还展示了系列影像学检查结果。胸椎前路减压、髂嵴支撑植骨及Kaneda器械固定取得了良好的功能效果。脊柱淀粉样瘤的症状和体征无特异性，难以诊断；因此，正确诊断需要外科医生高度怀疑。为此，特殊的组织化学染色至关重要。鉴于其罕见性，我们报告此病例并复习相关文献。
