Clinical analysis on 75 cases of subacute combined degeneration of the spinal cord

Abstract

Objective To summarize the clinical manifestations, laboratory, electrophysiological and imaging features, treatment and prognosis of subacute combined degeneration of the spinal cord (SCD). Methods and Results The clinical data of 75 SCD patients from February 2014 to February 2018 were collected and analyzed retrospectively. The etiology of SCD is related to disorders in uptake, absorption, combination or transport of vitamin B₁₂. The onset was chronic or subacute, and main initial symptoms were paresthesia of hands or feet. Laboratory examination showed elevated serum homocysteine (Hcy) levels, reduced vitamin B₁₂ levels and positive anti-intrinsic factor and anti-parietal cell antibodies. Spinal MRI showed that the lesions often occurred in the posterior and lateral funiculus of cervical and thoracic spinal cord. The "inverted V sign" was considered to be the characteristic imaging manifestation. All patients showed improved symptoms and signs to different degrees after vitamin B₁₂ treatment. Conclusions The pathogenesis of SCD is related to vitamin B₁₂ deficiency. The clinical manifestations are diverse. Spinal "inverted V sign" is a strong evidence for clear diagnosis, and vitamin B₁₂ is effective in the treatment of the disease.

DOI: 10.3969/j.issn.1672-6731.2019.04.011