腰椎间盘突出症合并马尾综合征7例报告

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。

Lumbar disc herniation with cauda equina syndrom

Objective:To explore the mechanism,treatment and prognosis of lumbar disc herniation with cauda equina syndrom. Methods: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.Follow-up 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 incontinenceand 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.