腰椎间盘突出症致马尾神经损伤的原因与防治

Analysis of the Cause of Cauda Equina Injury by Lumbar Intervertebral Disc Protrustion and its Prevention

目的 了解腰椎间盘突出症合并马尾神经损伤的发病原因 ,由此探讨其预防及治疗的措施。方法 对腰椎间盘突出症合并马尾神经损伤 2 1例进行分型、手术治疗和随访 ,并对发病原因及术中所见进行分析。结果 腰椎间盘突出症合并马尾神经损伤好发于腰椎间盘突出症反复多次发作者 ,多有外伤、不合理治疗等诱因。术后恢复优 5例 ,良 11例 ,可 4例 ,差 1例。结论 腰椎间盘突出症反复多次发作者其马尾神经损伤比例增加 ,对此类病人应避免腰部损伤 ,避免做重手法推拿、大重量牵引等加重腰部损伤的治疗 ,发现有马尾神经损伤者应作早期手术治疗。

Objective To analyse the cause of cauda equina injury by lumbar intervertebral disc protrusion and explore the measures for prevention and management.Methods 21 cases of lumbar intervertebral disc protrusion associated with cauda equina injury were analysed by grouping according to the findings during surgical treatment and follow up.Results Cauda equina injury increased in the individual who have lumbar leg pain for a long time,and the symptoms were often induced by trauama.The effect of surgical treatment was excellent in 5 cases,good in 11,fair in 4 and poor in 1.Conclusion The individual who often have symptoms of lumbar intervertebral disc protrusion episode should avoid injuries of the lumbar region,because that will increase the possibility of cauda equina injury.They must also avoid having heavy manipulation treatment.Traction using heavy weights should also be avoided.Early surgical treatment is the first choice for cases of lumbar disc protrusion associated with cauda equina injury.