Hosono N, Yonenobu K, Ono K
Department of Orthopaedic Surgery, Center for Adult Diseases, Osaka, Japan.
Spine (Phila Pa 1976). 1995 Oct 1;20(19):2147-50. doi: 10.1097/00007632-199510000-00014.
This is a report of a patient in whom spinal cord herniation into a pseudomeningocele resulted in progressive myelopathy.
To describe the outcome of a 59-year-old man who visited Osaka University Hospital complaining of gait disturbance. He had undergone cervical laminectomy to resect a spinal cord tumor 14 years previously.
Pseudomeningocele is an extremely rare condition and can be overlooked. In addition, cord herniation into the pseudomeningocele rarely can be diagnosed before surgical exploration. Our patient represents the first case we are aware of in which magnetic resonance imaging could clearly demonstrate not only the pseudomeningocele, but the herniation of the cord into the cyst.
Magnetic resonance imaging was used for preoperative and postoperative investigation.
The pseudomeningocele was resected to improve the neurologic status of the patient. During the operation, the herniated cord was successfully reduced into the original subarachnoid space by the release of adhesion. Most symptoms subsided soon after surgery. Magnetic resonance imaging could delineate not only the cyst and cord herniation, but the medullary pathology. The distribution of high-intensity areas on T2-weighted images suggested the cord damage.
Magnetic resonance imaging revealed not only the cyst and cord herniation, but medullary pathology, too.
本文报告一例脊髓疝入假性脊膜膨出导致进行性脊髓病的患者。
描述一名59岁男性患者的治疗结果，该患者因步态障碍就诊于大阪大学医院。他14年前曾接受颈椎椎板切除术以切除脊髓肿瘤。
假性脊膜膨出极为罕见，可能被忽视。此外，脊髓疝入假性脊膜膨出在手术探查前很少能被诊断出来。我们的患者是我们所知的首例磁共振成像不仅能清晰显示假性脊膜膨出，还能显示脊髓疝入囊肿的病例。
术前和术后均采用磁共振成像进行检查。
切除假性脊膜膨出来改善患者的神经状态。手术过程中，通过松解粘连成功地将疝出的脊髓回纳至原蛛网膜下腔。术后大多数症状很快缓解。磁共振成像不仅能描绘囊肿和脊髓疝出情况，还能显示脊髓病变。T2加权图像上高强度区域的分布提示脊髓损伤。
磁共振成像不仅显示了囊肿和脊髓疝出，还显示了脊髓病变。
