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脊椎神经瘤在腰部MRI上错过了:一个病例报告
Pengfei Zhang1, Ziyuan Zhang2, Wenqin Sun1
1Department of Anesthesiology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde, Hunan, China.
Frontiers in medicine
|March 16, 2026
概括
腰椎瘤可以模仿椎间盘,导致诊断延迟. 关节镜辅助脊柱手术有效地治疗了一个患有L5神经根神经瘤的患者,解决了疼痛和软弱.
科学领域:
- 神经外科 神经外科
- 脊柱外科手术 脊柱外科手术
- 在瘤学瘤学.
背景情况:
- 腰椎瘤是罕见的瘤,可以呈现出模仿常见脊柱状况 (如椎间盘) 的症状.
- 腰部神经瘤的延迟诊断可能会导致长时间的疼痛和神经系统缺陷.
研究的目的:
- 报告一个腰椎神经瘤被误诊为椎间盘的病例.
- 以突出诊断的挑战和成功管理的腰部神经瘤使用最少的侵入性技术.
主要方法:
- 一名55岁的男性患有持续下肢疼痛,接受了包括MRI和选择性神经根阻塞在内的诊断工作.
- 该患者接受了关节镜辅助单门脊椎手术 (AUSS) 治疗,用于内镜切除瘤.
- 手术后的组织病理学证实了神经瘤.
主要成果:
- 最初误诊为腰椎间盘,导致治疗延迟.
- 选择性神经根块和对比度增强的MRI对于准确的定位至关重要.
- AUSS内镜切除导致显著的疼痛减轻 (NRS在24小时内从7到2),并在2个月后完全消除症状.
结论:
- 腰部神经瘤可以潜伏地呈现,带来诊断挑战.
- 神经根块,先进的成像和组织病理学对于诊断至关重要.
- AUSS内镜为腰部神经瘤提供了微创和有效的治疗方法.
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