A case of thoracolumbar intravertebral canal extraction of an occupying lesion

Patient Wang***, female, 51 years old, from Donghai, Jiangsu, was admitted on 2015-7-8. Complaint: low back pain for one year, aggravated with weakness of both lower limbs for six months. The course of the disease was accompanied by strained bowel movements and poor urination. MRI of the thoracolumbar segment suggested that the thoracic 11, 12 vertebrae level intravertebral canal occupancy. On admission, muscle strength of the left lower limb was grade 1 and that of the right lower limb was grade 2. The knee tendon reflex was not elicited on the right side and was diminished on the left side, with bilateral Babinskin’s disease + and ankle clonus +. The patient complained of headache in the morning of the second postoperative day, which was considered to be a low cranial pressure headache due to partial loss of cerebrospinal fluid as a result of intraoperative dural incision. The patient was treated with positive pressure drainage of the incision, rehydration, low head and high foot position, constipation prevention and indwelling catheterization, etc. The headache was relieved after 2 days. He complained of numbness and pain in both lower extremities, and checked muscle strength: grade 2 in the left lower extremity and grade 4 in the right lower extremity. The patient and his family were advised to continue nerve nutrition and active+passive functional exercise. On July 16, the postoperative pathology results reported: spinal meningioma (epithelial type, WHO grade I) (T11/12 level). The incision was changed every other day after surgery. On the third day after surgery, the incision drained 10 ml of bloody fluid for 24 hours, and the drainage tube was removed.