Back to Search Start Over

Long-term outcome of idiopathic hypertrophic thoracic pachymeningitis.

Authors :
Tsutsui, Mio
Yasuda, Taketoshi
Kanamori, Masahiko
Hori, Takeshi
Kimura, Tomoatsu
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]

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