Intraspinal subcutaneous node refers to subcutaneous nodular granulomas located either outside the dura mater or beneath the dura mater, leading to spinal cord dysfunction. The primary clinical features are progressive symptoms and signs of spinal cord compression. Some scholars refer to it as atypical spinal tuberculosis (atypical spinal tuberculosis). Intraspinal subcutaneous nodular granulomas can occur at any age but are most commonly seen in young adults, with no significant difference in incidence between males and females. Epidural granulomas are more common than subdural granulomas, with a ratio of approximately 10:1.

bubble_chart Clinical Manifestations

The initial symptom in most patients is local pain at the lesion site. Many patients also present with subcutaneous nodules in other areas, such as pulmonary subcutaneous nodules or lymph node subcutaneous nodules, which provide diagnostic clues. Upon admission, all cases exhibited varying degrees of limb paralysis and fever (38–39°C), with tenderness and percussion pain at the affected spinous process.

bubble_chart Auxiliary Examination

1. Cerebrospinal fluid dynamics tests all showed complete or incomplete obstruction. The protein content of cerebrospinal fluid was increased to varying degrees, with the highest reaching 1000mg% or more. The cell count may be normal, but most show grade I elevation. The vast majority of cases exhibit an increased erythrocyte sedimentation rate.

2. Spinal X-rays mostly show no bone destruction or paravertebral cold abscess.

3. Myelography reveals scattered irregular filling defects, cup-shaped filling defects, or deformed nerve root sleeves, indicating subarachnoid space obstruction. MRI is of great diagnostic value for this disease.

Based on medical history, signs, cerebrospinal fluid dynamics tests, and radiographic findings, supplemented by CT and MRI, a diagnosis can be made.

bubble_chart Treatment Measures

Use anti-subcutaneous node drugs appropriately. In cases of spinal cord compression, perform an emergency laminectomy to remove subcutaneous node granulomatous tissue from the spinal canal.

bubble_chart Complications

Merge subcutaneous nodes from other areas such as pulmonary subcutaneous nodes, lymph node subcutaneous nodes, etc.