折針による頸髄損傷の1例

Cervical Spinal Cord Injury Caused by a Broken Acupuncture Needle: A case report

I．はじめに

　針治療は腰痛症，各種神経痛，頭痛をはじめ種々の病態に対し広く行われている．しかし，その合併症として稀に脊髄損傷をきたし，重篤な神経症状を呈する場合がある．今回われわれは．自分で行った針治療時の折針により脊髄症状を呈し，全身麻酔下に針を摘出し良好な結果を得た症例を経験したので報告する．

Spinal cord injury is a rare but considerable com-plication of acupuncture. A case with cervical spinal cord injury caused by a broken acupuncture needle was reported and sixteen previously reported cases includ-ing our case were reviewed.

A 49-year-old woman was treated by herself with acupuncture on the nuchal region for occipitalgia, and the needle was accidentally broken during the treat-ment. Six hours later she noticed pain and numbness in the right upper and lower extremities. Neurological ex-amination revealed slight impairment of temperature, pain and touch sensation on the right extremities. Plain X-ray film and CT scan showed a broken needle in the interspinous ligament between C1/C2 vertebrae, the tip of the needle appearing to be in the spinal canal. The needle was removed surgically nineteen days after the accident. Intraoperative fluoroscopic monitoring with injection of dye enabled the needle to be found without difficulty. Postoperative course was uneventful, and her pain and sensory impairment gradually disappeared.

Once the diagnosis for cervical spinal cord injury by an acupuncture needle is made, the needle should be re-moved surgically as soon as possible, especially prior to the development of motor symptoms. This is because movement of the needle in the spinal cord is considered to be a main possible cause of the development and progression of symptoms.