椎体腹側と脊柱管内に囊腫を合併した骨粗鬆症性圧迫骨折の1例

Ventral Spinal Cysts and Intraspinal Cysts after an Osteoporotic Compression Fracture. Case Report

　骨粗鬆症性脊椎圧迫骨折椎体から発生時期を異にして椎体腹側と脊柱管内に囊腫を生じ，脊柱管内囊腫により神経障害を来した稀な症例を経験した．症例は78歳の女性である．第1腰椎圧迫骨折受傷後2カ月で腰臀部痛の悪化とともに椎体前方に囊腫を生じた．その後，椎体前方の囊腫は消退したが骨折部は偽関節となり，骨折受傷後5カ月で脊柱管内囊腫を合併し，右下肢痛・しびれ・筋力低下を訴えて歩行困難となった．脊柱前方再建術を施行し良好な結果が得られた．偽関節部を安定化させることにより囊腫は消退した．

　We report the case of a 78-year-old woman who developed ventral spinal cysts and intraspinal cysts after an osteoporotic compression fracture.　Two months after an L1 compression fracture ventral cysts had developed, and the patient's low back pain and buttock pain had become severer.　The ventral cysts subsequently resolved, but the compression fracture became pseudarthrotic, and five months after the fracture intraspinal cysts had developed.　The patient developed neuropathy as a complication of the intraspinal cysts, and it was manifested by right leg pain, numbness, and muscle weakness.　This clinical course is rare.　Anterior spinal reconstruction was performed, and a good clinical outcome was achieved.　The intraspinal cysts resolved without resection.