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Neurology：颈椎椎体次全切除后出现脊髓疝

2019-12-24 zyx整理 神经科病例撷英拾粹

颈椎脊髓疝全身疼痛
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48岁男性，表现为逐渐加重的全身疼痛。患者既往有复杂的颈椎畸形行C2-T4前后器械融合。

48岁男性，表现为逐渐加重的全身疼痛。患者既往有复杂的颈椎畸形行C2-T4前后器械融合。神经系统查体，颅神经，感觉和肌力正常。影像学检查可见脊髓疝入椎体次全切除缺损处，且该部分脊髓出现软化（图）。患者疼痛考虑为脊髓软化所致。医源性脊髓疝（Spinal cord herniation，SCH）大多发生于后路内固定术（posterior instrumentation）后，常与假性脊膜膨出形成有关。SCH也可能为颈椎前路减压术后并发症，潜在的硬脊膜缺损是最可能的机制。


（图：A：T2WI；B：T1WI；C：增强T1WI；MRI可见脊髓向前疝入C5椎体次全切除缺损处；在此水平，颈髓明显变细，伴异常T2WI高信号，符合脊髓软化[A，箭]；增强前后T1WI未见任何异常强化）

原始出处：Guryildirim M, Kocak M, Dua SG. Teaching NeuroImages: Spinal cord herniation after cervical corpectomy.Neurology. 2019 Oct 29;93(18):e1744. 

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2080305, encodeId=34542080305dd, content=<a href='/topic/show?id=323c8462816' target=_blank style='color:#2F92EE;'>#脊髓疝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84628, encryptionId=323c8462816, topicName=脊髓疝)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=65c7309, createdName=fengxx, createdTime=Wed Nov 04 00:47:00 CST 2020, time=2020-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000941, encodeId=43cf20009413b, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jun 06 12:47:00 CST 2020, time=2020-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366865, encodeId=c0241366865e7, content=<a href='/topic/show?id=708a6283509' target=_blank style='color:#2F92EE;'>#椎体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62835, encryptionId=708a6283509, topicName=椎体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Thu Dec 26 13:47:00 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1517546, encodeId=7604151e54641, content=<a href='/topic/show?id=08dbe042428' target=_blank style='color:#2F92EE;'>#疝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70424, encryptionId=08dbe042428, topicName=疝)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5b7011086586, createdName=ms4657536712156177, createdTime=Thu Dec 26 13:47:00 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377405, encodeId=88db3e7405b4, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Wed Dec 25 08:56:57 CST 2019, time=2019-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377401, encodeId=9f8c3e740140, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Wed Dec 25 07:20:22 CST 2019, time=2019-12-25, status=1, ipAttribution=)]
    2020-11-04 fengxx

    #脊髓疝#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2080305, encodeId=34542080305dd, content=<a href='/topic/show?id=323c8462816' target=_blank style='color:#2F92EE;'>#脊髓疝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84628, encryptionId=323c8462816, topicName=脊髓疝)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=65c7309, createdName=fengxx, createdTime=Wed Nov 04 00:47:00 CST 2020, time=2020-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2000941, encodeId=43cf20009413b, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jun 06 12:47:00 CST 2020, time=2020-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366865, encodeId=c0241366865e7, content=<a href='/topic/show?id=708a6283509' target=_blank style='color:#2F92EE;'>#椎体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62835, encryptionId=708a6283509, topicName=椎体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Thu Dec 26 13:47:00 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1517546, encodeId=7604151e54641, content=<a href='/topic/show?id=08dbe042428' target=_blank style='color:#2F92EE;'>#疝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70424, encryptionId=08dbe042428, topicName=疝)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5b7011086586, createdName=ms4657536712156177, createdTime=Thu Dec 26 13:47:00 CST 2019, time=2019-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377405, encodeId=88db3e7405b4, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Wed Dec 25 08:56:57 CST 2019, time=2019-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=377401, encodeId=9f8c3e740140, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Wed Dec 25 07:20:22 CST 2019, time=2019-12-25, status=1, ipAttribution=)]
    2020-06-06 yinhl1978

    #Neurol#

    0

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    2019-12-26 dingxiaobo

    #椎体#

    0

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    2019-12-26 ms4657536712156177

    #疝#

    0

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    2019-12-25 一天没事干

    很好的学习机会

    0

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    2019-12-25 txqjm

    谢谢了，学习

    0

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