外傷性脊髄空洞症の1例

A Case Report of Post-traumatic Syringomyelia

I．はじめに

　脊髄外傷のあと数ヵ月から数年を経て損傷部位とは別の髄節に新たに痛みや筋萎縮と解離性知覚障害が起こり，これが脊髄内に生じた空洞に起因することは周知の事実であるが，この頻度は脊髄損傷症例の0.7-2.03％と極めて稀と報告されている^5,11,20）．またこの発生機序についても不明な点が多い．

　著者らも病歴と神経症状およびmetrizamide CTで確診し得た外傷性脊髄空洞症の1例を経験したので，症例の臨床経過を報告し，空洞の発生機序について考察を加える．

A case of posttraumatic syringomyelia which appeared 26 years after the injury was presented. A patient was 61 year old female, who sustained thoraco-lumbar spine injuries rendering her to paraplegic in 1954. Eleven months later she had an operation of T₆-T₉ and L₁-L₂ laminectomies and regained motor and sensory functions of the both lower extremities. She was ambulatory with crutches till 1979. In 1980, burning pain was noticed in the left scapular region, and thereafter, extended to the ulnar side of the left forearm. The pain became progressively worse and intractable. Analgesics were ineffective.