马尾神经功能障碍型腰椎间盘突出症的诊断与治疗

目的：介绍合并有马尾神经功能障碍的腰椎间盘突出症的诊断与治疗方法。方法：发生马尾神经功能障碍型腰椎间盘突出症的病人，大多为青壮年，强体力劳动者或体育运动员，因急性腰扭伤而发病。受伤后出现瘫痪症状和马鞍区麻痹、大小便失禁等现象，经X线拍片、CT和MRI检查，明确诊断后，应立即进行手术治疗。结果：作者报告10例，均经关节突间或半椎板切除入路，切除巨块型椎间盘，彻底减压马尾神经，术后均能得到良好的功能恢复，疼痛消失，唯大小便的功能恢复较迟，约在术后1～3周后尚能恢复。结论：马尾神经功能障碍型腰椎间盘突出症，应与马尾肿瘤相鉴别，一旦被确诊为巨块型腰椎间盘突出症，就应立即进行手术治疗，越早手术效果越好。

Diagnosis and Treatment of Lumbar Disc Herniation with Dysneuria Cauda Equina

Objective:To introduce the diagnosis and treatment of lumbar disc herniation complicated with dysneuria cauda equina.Methods:Lumbar disc herniation with dysneuria cauda equina was mostly occurred in young and consumedly physical laborer or sportsman,the cause of the disease was acute lumbar sprain.The injury may appeare the paralysed symptom,saddle zone paralysis and incontinence and so on.Through the examination of X-ray?CT and MRI,should do operative treatment immediately,once diagnosis was defined.Results:Ten cases were reported by authors,they were all adopted the approach of articular processus fenestration or hemilaminectomy to resect the huge lumbar disc and cauda equina nerve was decompressed completely.Postoperatively 10 cases all achieved a better dysfunctional recovery,and the pain has gone down too,but the dysfunctional,recovery of defecation and urination was about 1 to 3 weeks after. Conclusion: Lumbar disc herniation with dysneuria cauda equina should be distinguished with cauda equina tumor,if huge lumbar disc herniation was diagnozed,that should be operated immediately.The more earlier operation the more better effect.