颈、胸、腰椎管狭窄征误诊的原因(附1例报告并文献复习)

Analysis of Misdiagnosed Cervical,Thoracic and Lumbar Spinal Stensis:Report of One Case

目的分析探讨伴颈、臂麻痛,腰痛并双下肢无力、左膝关节肿痛症状的颈、胸、腰椎管狭窄征的误诊原因及诊治方法。方法对颈、胸、腰椎管狭窄征误诊为颈椎病、腰椎间盘突出症的患者病史、查体、影像学检查等进行综合分析,确诊后手术治疗。结果经常规行减压手术后左髋、膝关节疼痛大部分消失。肌力恢复,肌张力、腱反射等恢复正常。结论仔细询问病史,认真查体,将临床表现与影像学检查相结合进行综合分析,可有效降低误诊、误治率。胸椎管狭窄症应采用手术减压,不可滥用手法治疗。

Objective To analyze the reasons why cervical part, arm pain and numbness, low back pain with asthenia of both lower extremities, and left knee joint swelling and pain caused by cervical, thoracic and lumbar spinal stenosis were misdiagnosed, and to investigate how to treat it. Methods The patients of cervical, thoracic and lumbar spinal stenosis misdiagnosed as cervical spondylosis an..d lumbar intervertebral disc herniation were studied by comprehensive analysis of their case history, physical examination and imaging examination, etc. Furthermore, they were performed operation after finally confirmation of the diagnosis. Results On the basis of routine decompression via operation, not only the pains in the left hip and joint disappeared mostly, but also the muscle force, the muscle tension and the tendon reflex recovered to normal. Conclusion To inquest the case history, examine the body carefully, combine the clinical symptoms with imaging examination can degrade the misdiagnosis rate effectively. The cervical, thoracic and lumbar spinal stenosis ought to be treated with surgical operation to redueethe pressure.