UNASSIGNED: A 26-year-old male, non-alcoholic, non-smoker presented with complete paraplegia involving the bladder and bowel. His clinical examination did not show any gibbus. He was started on empirical antitubercular therapy and then referred to us as he failed to show improvement. An MRI of the spine showed extensive long-segment continuous spinal involvement with epidural abscess. The patient was taken for surgery with posterior decompression and instrumentation which was proven to be TB. He received complete treatment of 1 year and had complete recovery of his sensory and incomplete recovery of motor of lower limbs (became a wheelchair ambulator) with regain of bowel and bladder control at the end of treatment.
UNASSIGNED: This case report revealed that long-segment continuous STB without extensive destruction is atypical presentation. The clinical findings of paraplegia helped us to evaluate and clinch the diagnosis on MRI. However, the prognosis of rapid paraplegia remains guarded and patient had partial recovery of motor so he could become wheel chair ambulator only.
■一位26岁的男性,不含酒精,非吸烟者表现为累及膀胱和肠的完全截瘫。他的临床检查没有显示任何跳槽。他开始进行经验性抗结核治疗,然后由于未能表现出改善而向我们推荐。脊柱MRI显示广泛的长段连续脊柱受累,并伴有硬膜外脓肿。患者接受了后路减压和器械的手术,证明是TB。他接受了1年的完全治疗,感觉完全恢复,下肢运动不完全恢复(成为轮椅救护车),在治疗结束时恢复了肠和膀胱控制。
■该病例报告显示,没有广泛破坏的长段连续STB是非典型表现。截瘫的临床表现有助于我们评估和确定MRI的诊断。然而,快速截瘫的预后仍然受到保护,患者的运动部分恢复,因此他只能成为轮椅救护车。