右上葉胸壁合併切除後の脊髄梗塞

Spinal Cord Infarction after Right Upper Lobectomy Combined with Chest Wall Resection

脊髄梗塞は急性脊髄障害の5～8％とまれである．周術期においては大血管手術の合併症として重要であるが，その他の領域の合併症ではほとんど知られていない．われわれは，肺癌切除術後合併症としてはまれな脊髄梗塞を経験したので報告する．

A 42-year-old man presented with a one-month history of back pain. Chest computed tomography revealed a mass （7.6×5.7 cm） in the right upper lobe, suspicious of chest wall invasion. We performed right upper lobectomy combined with chest wall resection. Partial dissections of the second to sixth ribs and the third and fourth vertebral bodies were conducted. Postoperatively, motor paralysis of the right lower extremity was observed and a diagnosis of spinal infarction was made. After cerebrospinal fluid drainage and administration of edaravone with early rehabilitation, he was able to walk with a brace and was discharged from the hospital.