腰椎间盘突出症合并马尾综合征7例报告

Lumbar disc herniation with cauda equina syndrom

目的：探讨腰椎间盘突出症合并马尾神经综合征的发病机制、治疗及预后。方法：对7例腰椎间盘突出合并马尾综合征的病人进行回顾性分析。均以马尾神经综合征为首诊，且均进行了外科治疗。结果：有4例诊断和治疗均在马尾综合征症状出现后48小时内，其中3例手术在24小时内进行。另3例手术在症状出现48小时后进行，延误时间分别为5天、8天和25天。随访6个月-6年，平均3．5年。正常4例，有慢性疼痛和麻木1例。有持久的大小便失禁、肌力减退2例。所有病人均能够下床。结论：应将腰椎间盘突出症合并马尾综合征的病人作为外科急诊处理。

Objective： To explore the mechanism, treatment and prognosis of lumbar disc herniation with cauda equina syndrom. Methotis： A retrospective analysis was performed of 7 patients surgically treated for lumbar disc herniation who initially sought treatment for cauda equina syndrome. Results： In 4 patients , diagnosis was made and surgery performed within 48 hours of the cauda equina syndrome onset, including 3 patients（75% ） who underwent surgery within 24 hours. In 3 patients ,surgery was performed more than 48 hours after the onset of cauda equina syndrome, theis delay of 25 days , 8 days and 5 days . Followup ranged from 6 months to 6 years （mean, 3.5years）. Postoperatively, four patients were normal, one patient had chronic pain and numbness, and 2 patients had persistent incontineneeand weakness. All the patients were ambulatory. Conclusion： The data strongly support the management of cauda equina syndrome from lumbar disc herniation as a diagnostic and surgical emergency.