Movement disorders after intervertebral disc surgery:: Coincidence or causal relationship?
Movement disorders after intervertebral disc surgery:: Coincidence or causal relationship?
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DOI：
10.1002/mds.20152
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发表时间：
2004-10-01
影响因子：
8.6
通讯作者：
Krauss, JK
中科院分区：
文献类型：
--
作者：
Capelle, HH;Wöhrle, JC;Krauss, JK
众所周知，脑损伤或中枢创伤性病变可能导致随后出现肌张力障碍或震颤等运动障碍。神经结构的外周病变可能与运动障碍的发病机制有关这一概念一直存在争议，但直到最近才得到更广泛的接受。在此，我们报告了 6 名在椎间盘手术后出现运动障碍的患者。运动障碍在手术后延迟1天至12个月才显现出来。 6例患者中，4例接受颈椎间盘手术，2例因腰椎间盘突出症接受手术；阵发性运动性节段性肌张力障碍 2 例，局灶性肌张力障碍 1 例，单侧震颤 2 例，双侧震颤 1 例。运动障碍的出现与持续性皮肤或节段性疼痛有关。所有患者运动障碍的解剖分布均与相应椎间盘节段的神经根或脊髓节段有关，且其表现与手术时间关系密切。我们得出的结论是，椎间盘手术可能是迄今为止被忽视的运动障碍的另一个原因。所有患者的术后疼痛综合征均应被视为发病的重要因素。总体而言，与椎间盘手术相关的运动障碍似乎很少见，但可能会给患者带来明显的不适。 (C) 2004 年运动障碍协会。
It is well known that brain injury or central traumatic lesions may result in the subsequent appearance of movement disorders such as dystonia or tremor. The concept that peripheral lesions to neural structures may be involved in the pathogenesis of movement disorders has been discussed controversely but has gained more widespread acceptance only recently. Here, we report on 6 patients who developed movement disorders after spinal disc surgery. The movement disorders became manifest with a delay of I day to 12 months after surgery. Of the six patients, 4 underwent cervical disc surgery, and 2 patients were operated on for lumbar disc herniation; 2 patients presented with paroxysmal kinesigenic segmental dystonia, 1 patient with focal dystonia, 2 with unilateral tremor, and 1 with bilateral tremor. The appearance of the movement disorder was associated with persistent dermatornal or segmental pain. In all patients, the anatomic distribution of the movement disorder was related to the nerve root or spinal segment of the corresponding disc level and the manifestation was in close temporal relation to the surgery. We conclude that spinal disc surgery may be another, thus far neglected, cause for movement disorders. The postoperative pain syndrome in all patients should be considered as an important factor of pathogenesis. Overall, movement disorders associated with disc surgery appear to be rare, yet they may cause significant discomfort to the affected individual. (C) 2004 Movement Disorder Society.