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Rehabilitation Practice and Science

Translated Title

轉移性攝護腺癌合併腰椎壓迫性骨折及脊柱狹窄：病例報告暨文獻回顧

Abstract

We reported a 72 y/o male who had past history of old L1 compression fracture for 1 year. He suffered from falling down accidentally and was operated under impression of L1 burst fracture with cauda equina syndrome. He could ambulate with walker, but persistent back pain was still complained. Two months after operation, he became paralyzed rapidly in 2 days. Neurological examinations showed decreased motor strength of bilateral lower extremities to grade 0-1/5, sensory deficit below T10 dermatome and bilateral extensor plantar response. X-ray film showed an osteoblastic lesion in T9 vertebra body. Magnetic resonance Imaging (MRI) of thoracic spine revealed multiple iso-to-hyposignal intensity lesions diffusely involving of thoracic spine and compression of spinal cord at T9 level. Metastatic tumor was highly suspected. Prostate needle biopsy confirmed the primary origin of prostatic adenocarcinoma.This case illustrated that metastatic bone tumor should be considered as one of the etiologies of recurrent back pain, even in elderly patients with known history of compression fracture and spinal stenosis. We emphasize the importance of careful clinical examination of patients with back pain, including an assessment of motor strength, sensation, deep tendon reflexes and upper motor neuron signs. The use of spine radiographs and MRI is recommended for patients with back pain and bony destruction for early diagnosis of epidural spinal cord compression before the onset of neurologic symptoms.

Language

English

First Page

213

Last Page

219

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