- 期刊
Acute Paraplegia After Spinal Manipulation: A Case Report
整脊後導致急性截癱：病例報告
摘要
此案例是一名有慢性背痛病史的53歲女性，因整脊導致完全性截癱。CT和MRI圖像均顯示在T10─11、T11─12及L1─2等處合併有黃韌帶的骨化（ossification of ligamenta flava）和雙側的小面關節肥大（facet joint hypertrophy）。經診斷為脊髓損傷，T12截癱，ASIA-A。之後進行外科手術，在T10、T11、L1和L2進行椎板切除術（laminectomy）合併從T10到L2的椎間融合（interbody fusion）以利固定。經過術後的復健，病人雖然還是完全性截癱，但有提昇日常生活活動的功能性與生活品質。期望藉由本文讓社會大眾瞭解和注意整脊後可能發生急性截癱的風險。此外，當有症狀的惡化或是神經學上的症狀產生時，必須要及時的評估和治療，以避免造成不可挽回的傷害。
並列摘要
This is a case report about a 53-year-old female patient with a history of chronic back pain, suffered from complete paraplegia shortly after spinal manipulation. CT and MRI images consistently showed ossification of the ligamenta flava in conjunction with bilateral facet joints hypertrophy at the T10-11, T11-12 and L1-2 levels. Spinal cord injury with T12 paraplegia ASIA-A was thus diagnosed. Posterior laminectomy at the T10, T11, L1 and L2 levels and interbody fusion from T10 to L2 spines for fixation were performed. After rehabilitation, the patient regained some activities of daily living despite complete paraplegia. To raise public awareness, our report highlights the risk of acute paraplegia after forceful spinal manipulation. Furthermore, prompt evaluation and intervention is necessary when symptoms were worsen or neurological deficits were developed.