僵直性脊椎炎併發脊髓硬膜外血腫：病例報告

僵直性脊椎炎是一主要侵犯脊椎和關節的發炎性疾病，由於所有脊柱韌帶、關節、椎間盤進行性的骨化，且合併椎體骨質缺失，脊柱變為僵硬，即使受到輕微的外傷，也會造成嚴重的神經學病變。脊髓硬膜外血腫發生病因可能為外傷性或自發性，自發性比外傷性來的多。僵直性脊椎炎病患因外傷造成脊髓硬膜外血腫在臨床上相當罕見。本文報告一位64歲之男性，罹患僵直性脊椎炎約20年，因跌倒出現四肢無力，以核磁共振造影顯示頸、胸髓硬膜外血腫，經緊急減壓手術及復健治療後，神經功能恢復相當良好。此病例並不常見，早期適當診治對病患日後功能恢復影響很大，藉由此病例報告並回顧相關文獻資料，以做為臨床醫師處理類似疾病的參考。

關鍵字

脊髓硬膜外血腫；僵直性脊椎炎；減壓手術

並列摘要

Ankylosing spondylitis (AS) is an inflammatory disease that most commonly affects vertebral and pelvic joints. It is characterized by ossification of all spinal ligaments, articular joints, and intervertebral discs in association with osteoporosis of the vertebral bodies, thus, rendering the spine prone to trauma, which, even if minimal, may cause serious neurologic complications. Spinal epidural hematoma (SEH) is a rare clinical condition. Etiologically, it may be traumatic or nontraumatic. Spontaneous SEHs occur more frequently than traumatic SEHs. Although rare, posttraumatic SEH occurs frequently in patients with AS. We report the case of a 71-year-old male patient who suffered from AS for more than 20 years and experienced tetraplegia as a result of an accidental fall. Cervical and thoracic SEHs were diagnosed by magnetic resonance image. The neurologic recovery was successful after early decompression surgery and rehabilitation. The purpose of this case report is to remind clinicians that SEH, although rare, commonly occurs in patients with AS, and that early diagnosis and treatment can contribute to good functional recovery.

並列關鍵字

spinal epidural hematoma ； ankylosing spondylitis ； decompression operation

國際替代計量

僵直性脊椎炎併發脊髓硬膜外血腫：病例報告

全文下載

主題瀏覽