軽微な外傷後の癒着性くも膜炎により生じた難治性脊髄空洞症の 1 例

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The authors report a case of surgery resistant post-traumatic syringomyelia with arachnoiditis due to minor cervical cord injury. A 47-year-old man was admitted our institute with a 5-year history of progressive weakness of his left upper and lower extremities and numbness of right side of the body. He had an automobile accident when he was 23 years of age. At a local hospital in 1993, he underwent an anterior decompression and fusion at C2/3 for progressive weakness of left leg 2 years prior to his admission. Preoperative magnetic resonance (MR) imaging revealed not only disc protrusion at C2/3 but syrinx from C2 to C4. Neurologically he did not improve after the surgery and visited to us. MR imaging of our first admission revealed slightly enlarged syrinx from C1 to C4. He underwent partial dissection of adhesive arachnoiditis and syringo-subarachnoid shunt (S-S shunt) at the level of C2. However he did not improve after the surgery. he had been stable for 1 year after the surgery, when his gait became worsed, and MR imaging demonstrated syrinx extended from C1 down to T7, he underwent secondary S-S shunt at T2 level where arachnoiditis was not presented. After this second S-S shunt, the syrinx collapsed and his symptoms improved. In this case, syringomyelia is probably derived from subtle cervical cord injury which caused secondary arachnoiditis. It is necessary to choose correct surgical option for post-traumatic syringomyelia with archnoiditis.
1999-11-30

軽微な外傷後の癒着性くも膜炎により生じた難治性脊髄空洞症の 1 例

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