PDF(Pubmed)
Abstract：
BACKGROUND: At present, acute myelitis (AM) is a great challenge to diagnosis and treatment because of its complicated etiology, critical condition, and poor prognosis, and it is easy to leave different degrees of limb motor dysfunction. The report of this case is helpful to improve the understanding of AM after lumbar surgery, reduce misdiagnosis and provide reference for clinical treatment.
METHODS: This study reported a case of AM after lumbar reoperation. Before the patient was diagnosed as AM, we gave high-dose hormone anti-inflammatory and detumescence symptomatic treatment according to empirical treatment, and the effect was ideal and rehabilitation treatment was actively carried out at the right time. After 10 months of follow-up, the patient recovered well.
METHODS: Because lumbar surgery is a contraindication of lumbar puncture, the patient\'s diagnosis was confirmed by thoracic magnetic resonance imaging. Magnetic resonance imaging of thoracic vertebra on the 17th day after lumbar operation showed that small round T1W1 signal, slightly higher T2W1 signal and T2-fat suppression imaging equal signal were seen in the horizontal spinal cord of thoracic vertebra 10.
METHODS: According to the empirical treatment, patients have been given high-dose hormone therapy after operation, and comprehensive treatment such as comprehensive training of paraplegic limbs, joint loosening training, electric massage and other rehabilitation training will be carried out when the general condition of patients improves.
RESULTS: After 10 months of follow-up, there were no major sequelae such as limb paralysis.
CONCLUSIONS: Due to the rarity of AM in clinical work, it is easy for doctors to ignore the disease and miss the best treatment stage, which will lead to serious sequelae.
METHODS: This study reported a case of AM after lumbar reoperation. Before the patient was diagnosed as AM, we gave high-dose hormone anti-inflammatory and detumescence symptomatic treatment according to empirical treatment, and the effect was ideal and rehabilitation treatment was actively carried out at the right time. After 10 months of follow-up, the patient recovered well.
METHODS: Because lumbar surgery is a contraindication of lumbar puncture, the patient\'s diagnosis was confirmed by thoracic magnetic resonance imaging. Magnetic resonance imaging of thoracic vertebra on the 17th day after lumbar operation showed that small round T1W1 signal, slightly higher T2W1 signal and T2-fat suppression imaging equal signal were seen in the horizontal spinal cord of thoracic vertebra 10.
METHODS: According to the empirical treatment, patients have been given high-dose hormone therapy after operation, and comprehensive treatment such as comprehensive training of paraplegic limbs, joint loosening training, electric massage and other rehabilitation training will be carried out when the general condition of patients improves.
RESULTS: After 10 months of follow-up, there were no major sequelae such as limb paralysis.
CONCLUSIONS: Due to the rarity of AM in clinical work, it is easy for doctors to ignore the disease and miss the best treatment stage, which will lead to serious sequelae.
摘要：
背景：目前，急性脊髓炎(AM)因其病因复杂,对诊断和治疗提出了极大的挑战,危急情况,预后不良，容易留下不同程度的肢体运动功能障碍。该病例的报告有助于提高腰椎术后对AM的认识,减少误诊,为临床治疗提供参考。
方法：本研究报告1例腰椎再手术后AM。在患者被诊断为AM之前，根据经验性治疗给予大剂量激素抗炎消肿对症治疗，效果理想，及时积极进行康复治疗。经过10个月的随访，病人恢复得很好。
方法：因为腰椎手术是腰椎穿刺的禁忌症，患者的诊断经胸部磁共振成像证实。腰椎术后第17天胸椎磁共振成像显示小圆形T1W1信号,在胸椎水平脊髓中可见稍高的T2W1信号和T2-脂肪抑制成像等信号10。
方法：根据经验处理，患者术后接受大剂量激素治疗,以及截瘫肢体综合训练等综合治疗，关节松动训练,当患者的一般状况改善时，将进行电动按摩和其他康复训练。
结果：经过10个月的随访，没有肢体瘫痪等重大后遗症。
结论：由于AM在临床工作中的罕见性，医生很容易忽视疾病，错过最佳治疗阶段，这将导致严重的后遗症。
方法：本研究报告1例腰椎再手术后AM。在患者被诊断为AM之前，根据经验性治疗给予大剂量激素抗炎消肿对症治疗，效果理想，及时积极进行康复治疗。经过10个月的随访，病人恢复得很好。
方法：因为腰椎手术是腰椎穿刺的禁忌症，患者的诊断经胸部磁共振成像证实。腰椎术后第17天胸椎磁共振成像显示小圆形T1W1信号,在胸椎水平脊髓中可见稍高的T2W1信号和T2-脂肪抑制成像等信号10。
方法：根据经验处理，患者术后接受大剂量激素治疗,以及截瘫肢体综合训练等综合治疗，关节松动训练,当患者的一般状况改善时，将进行电动按摩和其他康复训练。
结果：经过10个月的随访，没有肢体瘫痪等重大后遗症。
结论：由于AM在临床工作中的罕见性，医生很容易忽视疾病，错过最佳治疗阶段，这将导致严重的后遗症。
