Rehabilitation Challenges and Outcome in a Patient with Thoracic Myelopathy due to Compression by Ossified Posterior Longitudinal Ligament in the Thoracic Spine: A Case Report

胸椎後縱韌帶骨化壓迫造成胸髓病變的復健挑戰與成效：個案報告

郭芳娟(Fang-Chuan Kuo) ； 張智雅(Chih-Ya Chang) ； 張幸初(Shin-Tsu Chang)

《澄清醫護管理雜誌》 15卷2期 (2019/04) Pp. 41-46

摘要

This study describes a 43-year-old woman with ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine for several years that resulted in the compression of the thoracic spinal cord, causing lower limb paralysis. Posterior laminectomy with decompression was immediately performed for severe spinal stenosis. However, thoracic myelopathy with lower limb paralysis remained postoperatively. After an intensive 2-month rehabilitation therapy, the muscle strength of both lower limbs increased to grade 4, and she could walk with assistance of a quad cane. Activities of daily living and quality of life significantly improved at one-year follow-up. In this case, we discuss postoperative lower limb paralysis and subsequent rehabilitation.

關鍵字

Ossification of the posterior longitudinal ligament ； Postoperative paralysis ； Rehabilitation ； Thoracic spine

並列摘要

本報告描述一位43歲女性的病情，其罹患胸椎後縱韌帶骨化數年，該骨化現象發生於胸椎，進而壓迫胸髓，造成下肢癱瘓。她很快地接受胸椎椎板切除與減壓手術，但術後胸髓病變合併下肢癱瘓仍持續存在，轉至復健科接受兩個月的積極復健治療後，兩下肢肌力已增至四分，甚至能在四腳拐杖的協助下開始步行，一年後，她的生活品質大為改善，可以獨立料理其日常生活。我們針對此案例的術後下肢癱瘓與後續復健加以討論。

並列關鍵字

後緃韌帶骨化 ； 手術後瘓癱瘓 ； 復健 ； 胸椎