[青少年神经根病伴硬膜外椎管内肿瘤]。

Acta ortopedica mexicana Pub Date : 2022-01-01
J Pavón-Flores, D Benavides-Rodríguez, P P Navarro-Ruíz, R González-Pino
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引用次数: 0

摘要

简介:扩张性脊柱内突通常有一个隐蔽的过程,使其早期诊断困难。脊髓内肿瘤根据其在椎管内的位置分为硬膜外和硬膜内,并分为髓外和髓内。一开始,它们会引起非特异性疼痛,有时还会引起根型疼痛。病人可能有以下症状:力量丧失、失去平衡、感觉丧失、括约肌紊乱。脊髓内肿瘤一经确诊,就有手术治疗的指征。材料和方法:我们描述了一名14岁男性青少年的临床病例,腰部疼痛四年,发作隐匿,间歇性,进行性,6个月前加重,放射到下肢,伴进行性感觉异常和瘫瘫,主要发生在右下肢。结果:行双侧L4、L5椎板切开术,探查切除肿瘤,释放神经根。肿瘤特征与脂肪组织相似,肿瘤内部有较宽的维管网,大小约为14 × 10 × 4mm,卵圆形,扁平,表面光滑有光泽。结论:脊柱肿瘤是一种较为罕见的肿瘤,但在这些肿瘤中,硬膜外椎管内的位置占一半。在我们的患者中,终丝脂肪瘤的诊断是完整的,它对应于脊柱所有肿瘤的不到1%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Adolescent radiculopathy associated with extradural intraspinal tumor].

Introduction: Expansive intra-spinal processes usually have an insidious course that makes their early diagnosis difficult. Intra-spinal tumors are classified according to their location in the spinal canal: extradural and intradural, and these are classified as extramedullary and intramedullary. At the beginning, they can cause non-specific pain conditions and, sometimes, root-type pain. The patient may have symptoms such as: loss of strength, loss of balance, loss of sensation, sphincter disorders. Intra-spinal neoplasms, when diagnosed, have an indication for surgical treatment.

Material and methods: The clinical case of a 14-year-old male adolescent is described, pain in the lumbar region for four years, of insidious onset, intermittent, progressive, exacerbated six months ago, with radiation to the lower extremities, which is accompanied by progressive paresthesia and paresis predominantly in the lower right limb.

Results: Bilateral L4 and L5 laminotomy is performed, exploration and resection of the tumor and release of nerve roots. Tumor with characteristics similar to adipose tissue is obtained, where a wide vascular network is observed inside, with an approximate size of 14 × 10 × 4 mm, ovoid in shape, flattened with a smooth and shiny surface.

Conclusion: Spinal tumors are relatively rare tumors, however, of these tumors, the extradural intraspinal location accounts for half of the cases. In our patient, the diagnosis of lipoma of the filum terminale was integrated, which corresponds to less than 1% of all tumors of the spine.

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