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相關文獻
- Paraplegia by Acute Cervical Disc Protrusion after Lumbar Spine Surgery
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- 頸椎退化性疾病
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| 題 名 | Paraplegia by Acute Cervical Disc Protrusion after Lumbar Spine Surgery=腰椎手術後因頸椎椎間盤突出導致急性下半身癱瘓 |
|---|---|
| 作 者 | 陳聖桓; 許汝寧; 余崇銘; 牛自健; 呂炳榮; | 書刊名 | 長庚醫學 |
| 卷 期 | 28:4 2005.04[民94.04] |
| 頁 次 | 頁254-257 |
| 分類號 | 416.61 |
| 關鍵詞 | 下半身癱瘓; 頸椎; 椎間盤突出; 腰椎; 椎板切除術; 術後併發症; Paraplegia; Cervical disc herniation; Lumbar laminectomy; Postoperative complication; |
| 語 文 | 英文(English) |
| 中文摘要 | 由於頸椎椎間盤突出導致非創傷性下半身癱瘓是罕見的術後併發症。一病例由於腰椎狹窄而接受椎板切除術。在術後一小時於麻醉恢復室發現下半身癱瘓合併胸部第6皮節以下感覺麻木,經核磁共指檢查發現第6至第7節頸椎椎間盤突出壓迫脊髓。雖經緊急手術作椎間盤切除,很遺憾病患的下半身癱瘓在3個月之後仍然沒有改善。在全身麻醉下肌肉鬆弛後喪失關節的支持保護能力,以及在插管及手術姿勢擺設的過程中會造成不穩定頸椎的移動,還有咳嗽及躁動引起頸部的劇烈運動,都是有可能誘發頸椎椎間盤突出的原因。從這個病例我們學習到退化性腰椎疾病患者,在手術全身麻醉前必須仔細評估是否有合併頸椎的問題,另一方面,要注意氣管內插管技巧以避免頸椎受傷,對於以俯臥姿手術的病患要特別小心頸部轉動可能造成的問題。 |
| 英文摘要 | Non-traumatic paraplegia caused by herniation of the cervical intervertebral disc is an uncommon postoperative complication. A patient with claudiation and radiculopathy was scheduled for lumbar laminectomy due to spinal stenosis. Postoperatively, numbness below T6 was found in his both legs of the patient. MRI showed a protruded intervertebral disc between C6 and C7. Despite urgent disectomy, the patient’s lower extremities remained paralyzed without significant improvement for 3 months. Loss of muscle support during general anesthesia, excessive neck extension during endotracheal intubation and positioning, as well as bucking and agitation are believed as triggering factors for the protrusion of the cervical disc. We suggest that a complete history taking and physical examination be accomplished in patients scheduled for lumbar spine surgery in order to exclude coexisting cervical spine disorders. In addition, skillful endotracheal intubation and careful neck positioning are mandatory for patients receiving surgery in the prone position. |
本系統中英文摘要資訊取自各篇刊載內容。