CAJ | 학술논문

目的：探讨腰髓海绵状血管瘤和腰椎滑脱的临床表现、病理特点、影像学特征、治疗及预后。方法某55岁女性患者，经腰椎X线、CT和MRI检查拟诊为L 4～5腰椎退行性滑脱、腰椎管狭窄伴L 5硬膜内髓外肿瘤，并行双侧L 4椎板切除减压术、L 4～5的PLIF+螺丝内固定和肿瘤切除术的外科手术治疗。结果术后患者左下肢和左侧臀部疼痛感消失，术后行走无明显不适。术后CT无明显异常，显示减压充分、固定满意。术后随访1年，患者无明显不适，生活自理。结论脊髓海绵状血管瘤和腰椎滑脱同时在一次手术报道不多，小心操作，充分减压、保护神经，建立坚强的内固定融合椎体是确保此类手术成功的关键。
목적：탐토요수해면상혈관류화요추활탈적림상표현、병리특점、영상학특정、치료급예후。방법모55세녀성환자，경요추X선、CT화MRI검사의진위L 4～5요추퇴행성활탈、요추관협착반L 5경막내수외종류，병행쌍측L 4추판절제감압술、L 4～5적PLIF+라사내고정화종류절제술적외과수술치료。결과술후환자좌하지화좌측둔부동통감소실，술후행주무명현불괄。술후CT무명현이상，현시감압충분、고정만의。술후수방1년，환자무명현불괄，생활자리。결론척수해면상혈관류화요추활탈동시재일차수술보도불다，소심조작，충분감압、보호신경，건립견강적내고정융합추체시학보차류수술성공적관건。
Objective To explore the clinical manifestations, pathological features, radiological features, treatment and prognosis of the spinal cavernous hemangioma and degenerative lumbar spondylolisthesis. Methods The minimally invasive surgery was preformed in a patient, who was female, 55-year-old, with left hip and left lateral thigh pain in 4 years, but had some effects with conservative treatment. One month ago before admission, she had suffered the left lower extremity pain significantly and much difficulty in walking, even intermittent claudication. The main imaging manifestations of the lumbar spine X-ray, CT and MRI included L 4~5 lumbar degenerative spondylolisthesis, lumbar spinal stenosis and L 5 intradural extra medullary tumor. The one-time surgery was performed, which was L 4~5 degenerative spondylolisthesis&intradural tumor at L 5,PLIF+pedicle screw, bilateral L 4 laminectomy and decompression. Results Postoperative patient had no symptom with left leg and left hip pain and no walking problems.Postoperative CT showed no obvious abnormality, sufficient decompression,fixation were satisfactory. The patient was followed up for one year,with not any discomfort, and can take care of herself. Conclusion The case was few reported, of one-time operation of spinal cord cavernous hemangioma associated with lumbar spondylolisthesis. The sufficient decompression, carefully protecting the nerve, build strong internal fixation fusion of vertebral body is the key to ensure the success of such operations.