• Medicine · Dec 2023

    Case Reports

    Iagnosis and treatment of myelitis after lumbar reoperation: A case report.

    • Dongru Li, Xiao Chen, Zifang Zhang, Xiao Liang, Xu Gao, Zhikang Tian, and Chunyang Meng.
    • Jining Medical University, Jining, China.
    • Medicine (Baltimore). 2023 Dec 8; 102 (49): e36361e36361.

    RationaleAt present, acute myelitis (AM) is a great challenge to diagnosis and treatment because of its complicated etiology, critical condition, and poor prognosis, and it is easy to leave different degrees of limb motor dysfunction. The report of this case is helpful to improve the understanding of AM after lumbar surgery, reduce misdiagnosis and provide reference for clinical treatment.Patients ConcernThis study reported a case of AM after lumbar reoperation. Before the patient was diagnosed as AM, we gave high-dose hormone anti-inflammatory and detumescence symptomatic treatment according to empirical treatment, and the effect was ideal and rehabilitation treatment was actively carried out at the right time. After 10 months of follow-up, the patient recovered well.DiagnosisBecause lumbar surgery is a contraindication of lumbar puncture, the patient's diagnosis was confirmed by thoracic magnetic resonance imaging. Magnetic resonance imaging of thoracic vertebra on the 17th day after lumbar operation showed that small round T1W1 signal, slightly higher T2W1 signal and T2-fat suppression imaging equal signal were seen in the horizontal spinal cord of thoracic vertebra 10.InterventionAccording to the empirical treatment, patients have been given high-dose hormone therapy after operation, and comprehensive treatment such as comprehensive training of paraplegic limbs, joint loosening training, electric massage and other rehabilitation training will be carried out when the general condition of patients improves.OutcomesAfter 10 months of follow-up, there were no major sequelae such as limb paralysis.ConclusionDue to the rarity of AM in clinical work, it is easy for doctors to ignore the disease and miss the best treatment stage, which will lead to serious sequelae.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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