腰椎黄色靭帯内に血腫を形成し下肢痛をきたした2症例 : 画像所見と発生機序

概要

論文の詳細を見る
In the literature ten cases of ligamentum flavum hematoma have been reported. Authors report here two cases of ligamentum flavum hematoma, showing their image studies and clinical features as to the mechanisms of hematoma formation, some speculations were suggested. The first case was a 64 year-old male who had had lower back pain for 8 years. He complained of severe pain from the left calf to the dorsal aspect of his first toe soon after suspension from a horizontal bar. When the left L4-5 partial hemilaminectomy was performed, a brown serous hematoma was found in the ligamentum flavum. His symptoms dramatically improved after surgery. The second case was a 75 year-old male who had had lower back pain for the last two years without an obvious history of trauma. When the right L3 partial hemilaminectomy was done, old hematoma with peripheric fibers intensely compressing the L4 nerve root were detected in the ligamentum flavum. His symptoms improved soon after surgery. One case showed acute progression and the other exhibited a chronic one. Hematoma in the first case bled from small arteries of the posterior spinal canal branch which might play an important role in the pathological mechanism. The second case was suspected to be caused by repeated injury of small capillary vesseles in sublaminar space.
日本脊髄外科学会の論文
2006-09-30