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A Rare Case of Multiregional Spinal Stenosis: Clinical Description Surgical Complication and Management Concept Review

机译:少见的多区域脊柱狭窄病例:临床描述手术并发症和管理理念审查。

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摘要

>Study Design Case report and literature review. >Objective Multiregional spinal stenosis (MRSS) has not been described in the English literature, although a few studies report the concept of tandem spinal stenosis. Due to the concurrent spinal stenosis occurring in three separate regions of the spine, clinical presentation of MRSS may be less distinct, and its surgical treatment priorities and challenges differ from single-region spinal stenosis. The purpose of this article is to describe a new concept and a rare case of MRSS as separated segments of spinal stenosis in the cervical, thoracic, and lumbar spine. >Methods A retrospective case description of MRSS and surgical strategies used in managing such extensive multiregional stenosis and its potential complications. >Results  A novel surgical strategy using a combination of laminectomies with fusion and laminoplasty without fusion to treat this patient with such extensive cervical to thoracic myelopathic cord compression is described. Initial good recovery after cervical cord decompression was followed by a delayed recurrence of symptoms from thoracic cord compression. The subsequent thoracic surgical decompression, its complications and management, and patient recovery are discussed with a literature review highlighting the possible mechanisms for postoperative loss of neurologic function after thoracic decompression. >Conclusion MRSS is a rare cause of extensive compression of multiple regions of the spinal cord. To the best of the authors' knowledge, this report is the first to use the term multiregional spinal stenosis to describe this new emergent clinical entity, surgical management strategies, and potential complications.
机译:>研究设计案例报告和文献复习。 >客观尽管一些研究报告了串联脊椎狭窄的概念,但英语文献中并未描述多区域脊椎狭窄(MRSS)。由于在脊柱的三个独立区域同时发生椎管狭窄,因此MRSS的临床表现可能不太明显,并且其手术治疗的重点和挑战与单区脊椎狭窄不同。本文的目的是描述MRSS的新概念和罕见案例,它们是颈椎,胸椎和腰椎中脊椎狭窄的分离部分。 >方法回顾性MRSS病例回顾及用于治疗此类广泛性多区域狭窄及其潜在并发症的手术策略。 >结果 described描述了一种新颖的外科手术策略,该方法结合了椎板切开术和融合术以及不融合的椎板成形术,以这种广泛的颈椎至胸廓脊髓压缩治疗该患者。颈椎减压后最初的良好恢复,随后是胸椎受压导致的症状延迟复发。随后的胸部外科手术减压,其并发症和处理方法以及患者的康复情况与文献综述进行了讨论,该文献强调了胸部减压后术后神经功能丧失的可能机制。 >结论 MRSS是广泛压迫脊髓多个区域的罕见原因。据作者所知,本报告是第一个使用术语多区域脊椎狭窄来描述这种新出现的临床实体,手术治疗策略和潜在并发症的报告。

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