腰椎椎间孔镜术后硬膜外腔积气一例报告
A Case Report of Epidural Gas Accumulation after Lumbar Foraminotomy
DOI: 10.12677/ACM.2023.13102130, PDF,   
作者: 钟 敏：湖北中医药大学第一临床学院，湖北 武汉
关键词: 硬膜外积气；腰椎椎间孔镜；神经系统症状；Epidural Gas Accumulation； Lumbar Foraminotomy； Neurological Symptoms
摘要: 报道一例后路腰椎椎间孔镜术后出现不寻常的症状性硬膜外气体积聚的病例，采用保守治疗后患者症状缓解。一名51岁女性在L4-5节段接受了后路腰椎椎间孔镜手术治疗，术后1小时患者腰及腿部疼痛症状较前无明显改变，且出现进行性四肢肌力下降及感觉异常等并发症。磁共振成像(MRI)和CT显示在背部腰段和胸段硬膜外间隙有巨大的积气形成。
Abstract: We report a case of unusual symptomatic epidural gas accumulation after posterior lumbar foraminotomy. The patient’s symptoms were relieved after conservative treatment. A 51-year-old woman underwent posterior lumbar foraminotomy surgery at L4 to 5. The symptoms of lumbar and leg pain did not change significantly 1 hour after surgery, and there was progressive muscle strength loss and paraesthesia in her limbs. Magnetic resonance imaging (MRI) and CT showed large air buildup in the lumbar and thoracic epidural spaces of the back.
文章引用：钟敏. 腰椎椎间孔镜术后硬膜外腔积气一例报告[J]. 临床医学进展, 2023, 13(10): 15227-15232. https://doi.org/10.12677/ACM.2023.13102130

参考文献

[1] Bang, W.S., Lee, W., Lee, Y.S. and Kang, B.U. (2020) Dorsal Epidural Gas after Lumbar Microdiskectomy Treated with CT-Guided Needle Aspiration. Korean Journal of Neurotrauma, 16, 305-312. [Google Scholar] [CrossRef] [PubMed]
[2] Cho, J.Y., Lee, S.H. and Lee, H.Y. (2011) Prevention of Develop-ment of Postoperative Dysesthesia in Transforaminal Percutaneous Endoscopic Lumbar Discectomy for Intracanalicular Lumbar Disc Herniation: Floating Retraction Technique. Minimally Invasive Neurosurgery, 54, 214-218. [Google Scholar] [CrossRef] [PubMed]
[3] 李平, 罗东, 罗林丽. 硬膜外腔压力及其影响因素的研究进展[J]. 广东医学, 2019, 40(15): 2262-2265.
[4] 张青林, 徐铭军. 剖宫产产妇硬膜外腔注药后压力与扩散速度及用药量的关系[J]. 临床麻醉学杂志, 2008, 24(10): 864-866.
[5] 李晓鸿, 韩月起, 董秋月. 颈内静脉压迫试验对硬膜外压力的影响及意义[J]. 山东医药, 2009, 49(39): 98-99.
[6] Thomas, P.S., Gerson, J.I. and Strong, G. (1992) Analysis of Human Epidural Pressure. Regional Anesthesia, 17, 212-215.
[7] Pratt, S.D., Kaczka, D.W. and Hess, P.E. (2014) Observational Study of Changes in Epidural Pressure and Elastance during Epidural Blood Patch in Obstetric Pa-tients. International Journal of Obstetric Anesthesia, 23, 144-150. [Google Scholar] [CrossRef] [PubMed]
[8] Romano-Ribeiro, C., Gaio-Lima, C., Ferreira, A.P., Oliveira, B., Dias-Vaz, M. and Camacho, Ó. (2022) Abnormal Motor Blockade after Epidural Analgesia Caused by Pneumorrhachis and the Role of Hyperbaric Oxygen Treatment: A Case Report. Diving and Hyperbaric Medicine, 52, 54-57. [Google Scholar] [CrossRef] [PubMed]
[9] Lee, C.W., Yoon, K.J., Ha, S.S. and Kang, J.K. (2014) Radicular Compression by Intraspinal Epidural Gas Bubble Occurred in Distant Two Levels after Lumbar Microdiscectomy. Jour-nal of Korean Neurosurgical Society, 56, 521-526. [Google Scholar] [CrossRef] [PubMed]
[10] Chen, Y., Yu, S.D., Lu, W.Z., Ran, J.W. and Yu, K.X. (2021) Epidural Gas-Containing Pseudocyst Leading to Lumbar Radiculopathy: A Case Report. World Journal of Clinical Cases, 9, 7279-7284. [Google Scholar] [CrossRef] [PubMed]
[11] Hu, D., Xu, K. and Xiao, S. (2022) Lumbar Radiculopathy Caused by Epidural Gas Collection. Case Reports in Orthopedics, 2022, Article ID: 8338131. [Google Scholar] [CrossRef] [PubMed]
[12] Kakitsubata, Y., Theodorou, S.J., Theodorou, D.J., Yuko, M., Ito, Y., Yuki, Y., Wada, S. and Maehara, T. (2009) Symptomatic Epidural Gas Cyst Associated with Discal Vacuum Phenome-non. Spine (Phila Pa 1976), 34, E784-E789. [Google Scholar] [CrossRef] 
[13] 李熊刚. 硬膜外麻醉空气压迫脊髓致死亡1例[J]. 重庆医学, 2015, 44(2): 285-286.
[14] 刘世喜, 赵松美, 刘华, 等. 硬脊膜外腔积气的处理体会[J]. 临床麻醉学杂志, 2012, 28(7): 722-723.
[15] 金昌莲, 刘环秋, 何其通, 等. 椎管内麻醉发生气颅和硬膜外间隙积气并发症二例[J]. 中华临床医师杂志(电子版), 2011, 5(24): 7465-7466.
[16] 石小军, 何宝龙, 王玉敏, 等. 硬膜外麻醉后硬膜外腔积气导致神经系统症状一例[J]. 临床麻醉学杂志, 2006(12): 964.
[17] 张维政, 程水勤. 剖宫产硬膜外积气导致神经系统症状1例[J]. 湖北中医杂志, 2012, 34(10): 63.
[18] Bin, Z., Chen, G., Shuai, X., et al. (2022) Efficacy and Safety of Epidural Anesthesia versus Local Anesthesia in Percutaneous Transforaminal Endoscopic Discectomy: A Sys-tematic Review and Meta-Analysis. Annals of Palliative Medicine, 11, 2676-2684. [Google Scholar] [CrossRef] [PubMed]

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