Herpes zoster mimicking spinal cord injury after endoscopic spine surgery: A case review.

IF 1.4 4区 医学 Q3 ORTHOPEDICS
Chang-Hyun Lee, Sung-Kyu Kim
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引用次数: 0

Abstract

BackgroundHerpes zoster mimicking radiculopathy after spinal surgery has been reported in some studies. But immediate onset of herpes zoster after spinal surgery has not been reported.ObjectiveThis case report aims to increase the awareness of the possible misdiagnosis of herpes zoster as iatrogenic nerve damage because of the occurrence of dermatome pain immediately after surgery.Case descriptionA 41-year-old man presented with a tingling sensation in the lower part of his left trunk and leg and mild gait disturbance. He was diagnosed with T10-11 ossification of the yellow ligament and underwent excision using biportal endoscopy. The operative course was uneventful; however, after waking up from anesthesia, he complained of severe pain and allodynia in his right lower abdomen corresponding to the T10-11-12 dermatome. We suspected spinal cord injury and administered high-dose corticosteroids.ResultsFollow-up MRI showed no significant nerve damage. On postoperative day 5, the patient developed erythematous papules, mainly along the distribution of the T5, T11 root dermatome, which was diagnosed as disseminated zoster.ConclusionHerpes zoster reactivation should be considered in differential diagnosis for new symptoms in a dermatomal distribution after spine surgery in the absence of other suspected iatrogenic causes during surgery.

脊柱内窥镜手术后模仿脊髓损伤的带状疱疹:病例回顾
背景:一些研究报道了脊柱手术后带状疱疹模拟神经根病。但是脊柱手术后立即发病的带状疱疹还没有报道。目的本病例报告旨在提高对因术后立即出现皮节疼痛而被误诊为医源性神经损伤的认识。病例描述:一名41岁男性患者表现为左躯干和腿部下部刺痛感和轻度步态障碍。他被诊断为T10-11黄韧带骨化,并通过双门静脉内窥镜手术切除。手术过程平安无事;然而,从麻醉中醒来后,他主诉右下腹T10-11-12皮肤区剧烈疼痛和异常性痛。我们怀疑脊髓损伤并给予大剂量皮质类固醇。结果随访MRI未见明显神经损伤。术后第5天,患者出现红斑丘疹,主要沿T5、T11根皮节分布,诊断为播散性带状疱疹。结论脊柱手术后若无其他疑似医源性原因,在皮皮分布出现新症状时,应考虑带状疱疹再激活作为鉴别诊断的依据。
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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
194
审稿时长
6 months
期刊介绍: The Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty. In each issue clinicians can find information which they can use in their patient setting the very next day.
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