腰椎间盘突出合并马尾神经综合征的手术效果

Effect of the operation lumbar disc herniation combines with cauda equina syndrome

目的：探讨腰椎间盘突出合并马尾神经综合征的手术效果。方法回顾性分析2008年1月至2014年3月收治的17例腰椎间盘突出合并马尾神经综合征患者的手术资料，总结其临床特点、手术方法及治疗效果。结果术后患者腰腿痛症状均有效缓解。出院随访12个月～4年，下肢肌力完全恢复10例，小腿关键肌肌力恢复1～2级7例；术前合并排尿功能障碍者7例，恢复5例，排尿无力、尿液残留2例；鞍区感觉恢复正常14例，遗留会阴部麻木感3例。疗效优良率为70．6%。结论腰椎间盘突出症合并马尾神经综合征患者神经受损、椎管狭窄程度与预后直接相关，临床应尽早明确诊断，及早手术减压，术后患者神经功能恢复需时较长，应注意随访。

Objective To investigate the effect of the operation lumbar disc herniation combines with cauda equina syndrome. Methods From January 2008 to March 2014, the clinical data of 17 pa-tients with lumbar disc herniation combines with cauda equina syndrome were retrospective analyzed. The clinical characteristics, surgical and therapeutic effects was summarized. Results Pain in waist and low-er extremities of the patients were remitted validly after the operation, and followed for 12 months to 4 years after the patients left the hospital found, 10 cases of patients got full-recovery on their low extremity muscle strength, 7 cases of patients got 1 to 2 level recoveries on their key muscle myodynamia. Five of 7 patients with urethral dysfunction before the operation have recovered, 2 cases of them with acraturesis and residual urine, 14 cases of patients’ sella area feeling recovered and 3 cases had feeling of numbness on their perineum. The good rate of clinical effect was 70. 6%. Conclusions The nerve injured and spi-nal canal stenosis degree of the patients with lumbar disc herniation combines with cauda equina syn-drome are directly correlate with their prognosis. The clinical should get a definite diagnosis and reduce the pressure through the operation as soon as possible. The neural functional recovery of the patients need a long stage, and the clinical should pay attention to the followup visit.