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患者男,71岁。6天前因肩部负重致腰扭伤,出现腰背部疼痛麻木并向双下肢放射,同时双下肢无力,不能行走,呈进行性加重。体查:胸4以下皮肤痛温觉减退,双下肢肌张力增高,肌力Ⅳ级,膝腱反射(+++),双踝阵挛(+),巴氏征(+),腹壁提睾反射(-)。脊髓造影示碘剂达胸5以上,通过障碍,临床诊断为胸4椎管内占位病变。术中见胸5、6间隙左侧一紫红色肿物,7×6×5cm,部分破溃,瘤体向左胸腔内伸入,触之易出血,胸5、6棘突及椎板被破坏,硬膜外脂肪消失,胸4处脊髓波动正
Patient male, 71 years old. 6 days ago lumbar sprain due to shoulder weight loss, numbness appeared lower back and back to the lower extremity radiation, while both lower extremities weakness, can not walk, was progressive increase. Physical examination: The following four cases of skin pain, hypothyroidism hypothyroidism, lower extremity muscle tone increased, grade IV, knee tendon reflex (+++), double ankle clonus (+), Pakistan’s sign (+ reflection(-). Myelography showed iodine up to chest 5, through the obstacles, the clinical diagnosis of chest 4 lesions in the spinal canal. Intraoperative see chest 5,6 left a purple mastoid tumor, 7 × 6 × 5cm, partial ulceration, the tumor extends into the left chest, touch the easy bleeding, thoracic 5,6, spinous process and lamina were Destruction, epidural fat disappeared, thoracic chest 4 fluctuations