腰椎管内神经鞘瘤误诊为腰椎间盘突出症1例  

Lumbar spinal neurilemmoma misdiagnosed as lumbar disc herniation:A report of 1 case

作　　者：李贝贝 邹欣欣[1] 付青松[1] 崔西龙[1] 于海洋[1] LI Beibei;ZOU Xinxin;FU Qingsong;CUI Xilong;YU Haiyang(Department of Orthopaedics,Fuyang People's Hospital,Fuyang Clinical College of Anhui Medical University,Fuyang,Anhui 236000,China)

机构地区：[1]安徽医科大学阜阳临床学院(阜阳市人民医院)骨科,安徽阜阳236000

出　　处：《安徽医药》2022年第3期514-516,共3页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省科技厅2017年重点研究与开发计划立项项目(1704a0802159)。

摘　　要：目的总结1例腰椎管内神经鞘瘤被误诊为腰椎间盘突出症病人的诊疗过程,积累该类病人的临床诊疗经验。方法回顾性分析2019年10月阜阳市人民医院脊柱病区收治的1例腰椎管内神经鞘瘤易被误诊为腰椎间盘突出症病人诊疗的临床资料,探讨其疾病特点及易被误诊原因。结果病人主诉腰痛伴左下肢麻木、疼痛1年,加重2周。入院诊断:腰椎间盘突出症L4/5。后进行增强磁共振成像(MRI)检查,提示L5椎管及L5/S1左侧椎间孔肿瘤。对该病人进行手术治疗,术后预防感染,术后第2天病人临床症状较术前明显缓解,手术效果佳。结论腰椎管内神经鞘瘤少见,临床缺乏特异性,应尽早与其他相关疾病进行鉴别,避免误诊误治。Objective To summarize the diagnosis and treatment of one case of lumbar spinal neurilemmoma misdiagnosed as lum⁃bar disc herniation,and to gain experience of clinical practice of such patients.Methods The clinical data of one case of lumbar spi⁃nal neurilemmoma likely to be misdiagnosed as lumbar disc herniation treated in Fuyang People's Hospital in October 2019 were ana⁃lyzed retrospectively,and the disease characteristics and causes of misdiagnosis were discussed.Results The patient complained of low back pain accompanied by numbness and pain in the left lower limb for 1 year and aggravation for 2 weeks.Admission diagnosis was lumbar disc herniation L4/5.Later,enhanced MRI revealed tumors in the spinal canal of L5 and left intervertebral foramen of L5/S1.The patient underwent operation and measures were taken to prevent postoperative infection.The clinical symptoms of the patients were significantly relieved on the second day after operation,and the operation effect was good.Conclusions Lumbar spinal neurilem⁃moma is rare and lack of specificity in clinic practice.It is necessary to differentiate it from other related diseases as early as possible so as to avoid misdiagnosis and therapeutic error.

关 键 词：神经鞘瘤 误诊 腰椎间盘突出症 

分 类 号：R739.42[医药卫生—肿瘤]