椎间盘突出致马尾神经综合征的手术疗效及康复分析

Operative effect and analysis of postoperative rehabilitation factors of the cauda equina syndrome secondary to lumbar disc herniation

目的: 回顾性分析 62例马尾神经综合征病人, 探讨病人术后康复的影响因素。方法: 对 62例马尾神经综合征患者的临床表现、手术时间、手术方式与术后随访结果进行综合分析。结果: 不完全性的CES恢复要好于完全性损伤, 急性CES病人术前没有后腰痛表现的病人恢复好于有后腰痛病史的病人。急性CES组病人 24h内减压与 48h内减压没有明显的愈后差别, 但 48h内减压与 48h以上组减压有明显差别。慢性CES组病人与急性组病人愈后没有明显差别。全椎板截骨回植术后康复要好于椎间隙及半椎板组。结论: 手术治疗是马尾神经综合征首选治疗方法, 急性发病者手术时间与愈后明显相关, 慢性发病者手术时间与愈后无明显的关系, 病人术前症状、手术方法、损伤的严重程度是影响愈后的重要因素。

Objective:Through retrospective analysis of 62 cases of cauda equina syndrome (CES),to find out the postoperative rehabilitation factors which affect the operative result.Method:Analyzed the clinical symptom、operative time、methods and results of the 62 cases comprehensively.Result:The rehabilitaion of uncompletely CES group was prior to the completely group.The rehabilitation of acute group without chronic back pain was prior to the group with the chronic back pain. The acute group who underwent decompression within 24h had no difference with the group within 48h,but the group who underwent decompression within 48h had significant difference with the group more than 48h. The chronic group had no significant difference with the acute group.The rehabilitation of the all lamina cutting-replacing was prior to the group of intervertebral space and the group of hemi-lamina.Conclusion:The therapy of operative is the first method for the cauda equina syndrome.The operative time has the obvious correlitative with the rehabilitation in the acute patients. The operative time has no obvious relation with the rehabilitation in the chronic group.The preoperative syndrome and the operative method and the lesion degree of the cauda equina are the important influence factors.