Spontaneous haematoma of ligamentum flavum. Case report and literature review.
Spontaneous haematoma of ligamentum flavum. Case report and literature review.
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黄韧带自发性血肿。
DOI：
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发表时间：
2006
影响因子：
1.9
通讯作者：
A. Mangiola
中科院分区：
文献类型：
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作者：
A. Albanese;A. Braconi;C. Anile;S. Mannino;G. Sabatino;A. Mangiola
自发性黄韧带梗塞是一种非常罕见的神经根压迫的原因。在文献中只有四个病例被报道，所有病例的特征都是缓慢进展的微神经根病的临床病史和手术治疗后的良好结果。1例70岁女性患者，临床表现为4个月自发性、亚持续性、进行性腰痛，双侧L4-L5皮肤科放射，右腿单瘫，感觉减退，影响触觉、温度和疼痛敏感性，尿失禁和便秘。CT扫描和MRI证实对应于L1-L2节段的卵圆硬膜外病变，对硬膜囊施加压迫，使其向前移位。患者接受了L1-L2椎板切除术，病变被完全切除。患者的症状在术后期间迅速改善，并在接下来的一个月内完全恢复。组织学检查显示肿块为黄韧带血肿。我们认为，在鉴别诊断脊神经后根压迫时，应考虑黄韧带血肿的照片。血肿的进行性增长可能解释了这些患者的长期临床病史和手术治疗，即使延迟，也可以获得更好的临床结果。
Spontaneous infarction of the ligamentum flavum is a very rare cause of mielo-radicular compression. In the literature only four cases are reported, all characterized by a clinical history of slowly progressive mielo-radiculopathy and good outcome after surgical treatment. A 70 year-old female patient presented with a four months clinical history of spontaneous, sub-continuous, progressive lumbar pain with bilateral irradiation to the L4-L5 dermatomers, right leg monoparesis and hypoaesthesia affecting tactile, thermal and pain sensivity, urinary incontinence and constipation. CT scan and MRI evidenced an extradural ovalar lesion in correspondence of the L1-L2 levels, that exerted compression over the dural sac, dislocating it anteriorly. The patient underwent a L1-L2 laminectomy and the lesion was totally resected. Rapid improvement of the patient's symptomatology has been noticed in the postoperative period, with complete recovery during the following month. Histologic examinations demonstrated that the mass was a haematoma of the ligamentum flavum. It's our opinion, that a picture of ligamentum flavum haematoma should be taken into account in differential diagnosis of posterior mielo-radicular compression. The progressive growth of the haematoma may explain the long clinical history of these patients and surgical treatment, even if delayed, permits an excel-lent clinical outcome.