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Long-term outcome of idiopathic hypertrophic thoracic pachymeningitis.
- Source :
- European Spine Journal; Jun2012, Vol. 21, p404-407, 4p, 1 Color Photograph, 1 Black and White Photograph, 1 Chart
- Publication Year :
- 2012
-
Abstract
- Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a comparatively rare disease characterized by hypertrophic inflammation of the dura mater and clinical symptoms that progress from local pain to myelopathy. We report a case of IHSP followed up for 20 years in a 46-year-old man. Expansive laminoplasty was performed in 1991, and this case has been previously reported by a co-author. After 17 years, the patient's gait disturbance returned. Physical examination and imaging confirmed IHSP that had developed into syringomyelia at the T2-L1 conus level. This case was diagnosed as adhesive spinal arachnoiditis due to pachymeningitis caused by syringomyelia. T1-T4 laminectomy, a syringo-subarachnoid shunt (S-S shunt), and L2-L3 laminectomy were performed. The patient again developed dysesthesia and gait disturbance 3 years after the second operation. Most reports of IHSP have limited their focus to short-term follow-up after initial treatment with no long-term results. At present, there are only five reports referring to long-term results of greater than 5 years. All but one case needed additional surgery. To the best of our knowledge, this is the first case in which syringomyelia occurred in a patient with IHSP. It is important to note that syringomyelia may be a cause of symptom recrudescence during long-term follow-up in IHSP patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- CASE studies
ESSENTIAL hypertension
PACHYMENINGITIS
SYRINGOMYELIA
DISEASE relapse
Subjects
Details
- Language :
- English
- ISSN :
- 09406719
- Volume :
- 21
- Database :
- Complementary Index
- Journal :
- European Spine Journal
- Publication Type :
- Academic Journal
- Accession number :
- 76374071
- Full Text :
- https://doi.org/10.1007/s00586-011-1848-9