手术治疗痛风石性腰椎管狭窄1例报告
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摘要
<正>患者男性,20岁,学生,因"腰痛活动受限伴双侧臀部痹痛1月余"于2017年12月来我院就诊。患者1个月前无明显外伤下,开始出现腰背疼痛,伴双侧臀部痹痛,无明显双下肢放射痛,间断门诊行保守治疗,症状反复发作。既往痛风性关节炎病史,但未系统治疗。查体:体型肥胖,BMI指数31。腰椎活动明显受限,以前屈、后伸为主,下蹲受限,L_(3,4)、L_(4,5)椎间隙压痛及叩击痛阳性,双侧髋"4"字试验阴性,双
引文
[1] Yoon JW,Park KB,Park H,et al. Tophaceous gout of the spine causing neural compression[J]. Korean J Spine,2013,10(3):185-188.
[2] Hasturk AE,Basmaci M,Canbay S,et al.Spinal gout tophus:a very rare cause of radiculopathy[J]. Eur Spine J,2012,21(Suppl4):400-403.
[3]Thavarajah D,Hussain R,Martin JL. Cervical arthropathy caused by gout:stabilisation without decompression[J]. Eur Spine J,2011,20(Suppl 2):S231-S234.
[4]唐超,廖烨晖,唐强,等.痛风石导致腰椎管狭窄症1例[J].中国骨伤,2018,31(8):779-782.TANG C, LIAO YH, TANG Q, et al. Lumbar canal stenosis caused by gout:a case report[J]. Zhongguo Gu Shang/China J Orthop Trauma,2018,31(8):779-782. Chinese.
[5]吕龙龙,陈龙,黄琦,等.硬膜外脂肪瘤内痛风石形成致脊髓压迫症1例[J].中国骨伤,2018,31(3):279-280.LYU LL,CHEN L,HUANG Q,et al. Spinal cord compression caused by tophus in epidural lipoma:a case report[J]. Zhongguo Gu Shang/China J Orthop Trauma,2018,31(3):279-280. Chinese.
[6]卫成军,王文岳,谢利民,等.痛风结晶致胸椎管狭窄症1例[J].中国骨伤,2016,29(7):665-667.WEI CJ,WANG WY,XIE LM,et al. Diagnosis and treatment for thoracic spinal stenosis caused by tophaceous gout:a case report[J]. Zhongguo Gu Shang/China J Orthop Trauma,2016,29(7):665-667. Chinese.
[7] Kersley GD,Mandel L,Jeffrey MR. Gout:an unusual case with softening and subluxation of the first cervical vertebra and splenomegaly[J]. Ann Rheum Dis, 1950,9(4):282-304.
[8] Koskoff YD,Morris LE,Lubic LG. Paraplegia as a complication of gout[J]. J Am Med Assoc, 1953,152(1):37-38.
[9] Kao MC,Huang SC,Chiu CT,et al. Thoracic cord compression due to gout:a case report and literature review[J]. J Formos Med Assoc,2000,99(7):572-575.
[10] Lam HY,Cheung KY,Law SW,et al. Crystal arthropathy of the lumbar spine:a report of 4 cases[J]. J Orthop Surg(Hong Kong),2007,15(1):94-101.
[11] Hou LC,Hsu AR, Veeravagu A,et al. Spinal gout in a renal transplant patient:a case report and literature review[J]. Surg Neurol,2007,67(1):65-73.
[12]冉兵,魏俊.痛风石诊断与治疗的研究进展[J].中国骨伤,2017,30(9):876-880.RAN B, WEI J. Progress on diagnosis and treatment of tophus[J].Zhongguo Gu Shang/China J Orthop Trauma,2017,30(9):876-880. Chinese.
[13]吕冬亮,陆雪华.双手双足痛风性关节炎合并巨大痛风结节钙化1例[J].中国骨伤,2009,22(12):955.LYU DL,LU XH. Gouty arthritis of hands and feet combined with giant calcified tophus:a report of 1 case[J]. Zhongguo Gu Shang/China J Orthop Trauma,2009,22(12):955. Chinese.
[14] Yoon JW,Park KB,Park H,et al. Tophaceous gout of the spine causing neural compression[J]. Korean J Spine,2013,10:185-188.
[15] Wendling D,Prati C,Hoen B,et al. When gout involves the spine:five patients including two inaugural cases[J]. Joint Bone Spine,2013,80(6):656-659.
[16] Lu F,Jiang J,Zhang F,et al. Lumbar spinal stenosis induced by rare chronic tophaceous gout in a 29-year-old man[J]. Orthopedics,2012,35(10):E1571-E1575.
[17] Yamamoto M,Tabeya T,Masaki Y,et al. Tophaceous gout in the cervical spine[J]. Intern Med,2012,51(3):325-328.
[18] Dalbeth N,Aati O,Kalluru R,et al. Relationship between structural joint damage and urate deposition in gout:a plain radiography and dual-energy CT study[J]. Ann Rheum Dis,2015,74(6):1030-1036.
[19] Hu HJ,Liao MY,Xu LY. Clinical utility of dual-energy CT for gout diagnosis[J]. Clin Imaging,2015,39(5):880-885.
[20] Draganescu M,Leventhal LJ. Spine gout:case report and review of the literature[J]. J Clin Rheumatol,2004,10(2):74-79.
[21] Dhote R, Roux FX,Bachmeyer C, et al. Extradural spinal tophaceous gout:evolution with medical teatment[J]. Clin Exp Rheumatol, 1997,15(4):421-423.
[22] King JC, Nicholas C. Gouty arthmpathy of the lumbar spine:a case report and review of the literature[J]. Spine(Phila Pa 1976),1997,22(19):2309-2312.
[2] Hasturk AE,Basmaci M,Canbay S,et al.Spinal gout tophus:a very rare cause of radiculopathy[J]. Eur Spine J,2012,21(Suppl4):400-403.
[3]Thavarajah D,Hussain R,Martin JL. Cervical arthropathy caused by gout:stabilisation without decompression[J]. Eur Spine J,2011,20(Suppl 2):S231-S234.
[4]唐超,廖烨晖,唐强,等.痛风石导致腰椎管狭窄症1例[J].中国骨伤,2018,31(8):779-782.TANG C, LIAO YH, TANG Q, et al. Lumbar canal stenosis caused by gout:a case report[J]. Zhongguo Gu Shang/China J Orthop Trauma,2018,31(8):779-782. Chinese.
[5]吕龙龙,陈龙,黄琦,等.硬膜外脂肪瘤内痛风石形成致脊髓压迫症1例[J].中国骨伤,2018,31(3):279-280.LYU LL,CHEN L,HUANG Q,et al. Spinal cord compression caused by tophus in epidural lipoma:a case report[J]. Zhongguo Gu Shang/China J Orthop Trauma,2018,31(3):279-280. Chinese.
[6]卫成军,王文岳,谢利民,等.痛风结晶致胸椎管狭窄症1例[J].中国骨伤,2016,29(7):665-667.WEI CJ,WANG WY,XIE LM,et al. Diagnosis and treatment for thoracic spinal stenosis caused by tophaceous gout:a case report[J]. Zhongguo Gu Shang/China J Orthop Trauma,2016,29(7):665-667. Chinese.
[7] Kersley GD,Mandel L,Jeffrey MR. Gout:an unusual case with softening and subluxation of the first cervical vertebra and splenomegaly[J]. Ann Rheum Dis, 1950,9(4):282-304.
[8] Koskoff YD,Morris LE,Lubic LG. Paraplegia as a complication of gout[J]. J Am Med Assoc, 1953,152(1):37-38.
[9] Kao MC,Huang SC,Chiu CT,et al. Thoracic cord compression due to gout:a case report and literature review[J]. J Formos Med Assoc,2000,99(7):572-575.
[10] Lam HY,Cheung KY,Law SW,et al. Crystal arthropathy of the lumbar spine:a report of 4 cases[J]. J Orthop Surg(Hong Kong),2007,15(1):94-101.
[11] Hou LC,Hsu AR, Veeravagu A,et al. Spinal gout in a renal transplant patient:a case report and literature review[J]. Surg Neurol,2007,67(1):65-73.
[12]冉兵,魏俊.痛风石诊断与治疗的研究进展[J].中国骨伤,2017,30(9):876-880.RAN B, WEI J. Progress on diagnosis and treatment of tophus[J].Zhongguo Gu Shang/China J Orthop Trauma,2017,30(9):876-880. Chinese.
[13]吕冬亮,陆雪华.双手双足痛风性关节炎合并巨大痛风结节钙化1例[J].中国骨伤,2009,22(12):955.LYU DL,LU XH. Gouty arthritis of hands and feet combined with giant calcified tophus:a report of 1 case[J]. Zhongguo Gu Shang/China J Orthop Trauma,2009,22(12):955. Chinese.
[14] Yoon JW,Park KB,Park H,et al. Tophaceous gout of the spine causing neural compression[J]. Korean J Spine,2013,10:185-188.
[15] Wendling D,Prati C,Hoen B,et al. When gout involves the spine:five patients including two inaugural cases[J]. Joint Bone Spine,2013,80(6):656-659.
[16] Lu F,Jiang J,Zhang F,et al. Lumbar spinal stenosis induced by rare chronic tophaceous gout in a 29-year-old man[J]. Orthopedics,2012,35(10):E1571-E1575.
[17] Yamamoto M,Tabeya T,Masaki Y,et al. Tophaceous gout in the cervical spine[J]. Intern Med,2012,51(3):325-328.
[18] Dalbeth N,Aati O,Kalluru R,et al. Relationship between structural joint damage and urate deposition in gout:a plain radiography and dual-energy CT study[J]. Ann Rheum Dis,2015,74(6):1030-1036.
[19] Hu HJ,Liao MY,Xu LY. Clinical utility of dual-energy CT for gout diagnosis[J]. Clin Imaging,2015,39(5):880-885.
[20] Draganescu M,Leventhal LJ. Spine gout:case report and review of the literature[J]. J Clin Rheumatol,2004,10(2):74-79.
[21] Dhote R, Roux FX,Bachmeyer C, et al. Extradural spinal tophaceous gout:evolution with medical teatment[J]. Clin Exp Rheumatol, 1997,15(4):421-423.
[22] King JC, Nicholas C. Gouty arthmpathy of the lumbar spine:a case report and review of the literature[J]. Spine(Phila Pa 1976),1997,22(19):2309-2312.