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患者,男性,57岁。因腰痛伴双下肢麻木,进行性加重16年,右足背屈功能障碍2年,行走受限,大便失控,小便不畅4天,于1991年4月18日入院。16年前患者自觉无明显诱因感腰背部胀痛,并向双下肢放射。按腰椎间盘突出症行按摩、理疗、局部封闭治疗,无好转。继而出现上升性、进行性双下肢无力,时有放射性疼痛及双下肢麻木。入院前4天,渐感行走不便,大小便失控加重,来我院就诊。查体:脑神经无异常,脊柱外观无畸形,腰_1椎体压痛明显,并沿腰_1脊神经分布区域放射,胸_5以下触觉减弱。痛觉存在,右膝关节以下痛觉均减退,触觉消失。右足背屈功能受限,肌力左下肢Ⅱ级,右下肢Ⅱ级。双下肢肌张力低,腱反射减低,右踝阵挛阳性。胸腰椎正侧位X线摄片无异常。CT扫描腰椎无异常发现,椎管造影胸_(11)平面
Patient, male, 57 years old. Due to low back pain with double lower extremity numbness, progressive aggravating 16 years, right dorsiflexion dysfunction 2 years, limited walking, stool uncontrollably, poor urination 4 days, in April 18, 1991 admission. 16 years ago, patients consciously no obvious incentive to lower back pain, and to lower extremity radiation. Press lumbar disc herniation massage, physiotherapy, partial closed treatment, no improvement. Followed by rising, progressive weakness in both lower extremities, sometimes with radiological pain and numbness in both lower extremities. 4 days before admission, gradually walking inconvenience, exacerbation of uncontrolled urine, to our hospital. Physical examination: no abnormalities of the cranial nerves, no deformity of the spine appearance, obvious tenderness of the lumbar vertebrae 1, and radiation along the distribution area of the lumbar vertebrae 1 nerve. Pain exists, the pain below the right knee are diminished, touch disappears. Right dorsiflexion limited function, muscle left lower extremity Ⅱ, right lower extremity Ⅱ. Lower extremity muscle tone is low, tendon reflexes reduce, right ankle clonus positive. Thoracolumbar positive lateral X-ray no abnormalities. CT scan of the lumbar spine without abnormal findings, spinal imaging chest _ (11) plane