腰椎间盘突出症合并马尾神经综合征的临床研究

目的通常认为腰椎间盘突出症患者如果并发马尾神经综合征，一经诊断应立即手术。即使早期手术，临床中仍发现有部分患者膀胱功能无法恢复，对此类患者膀胱及括约肌功能恢复程度的判断对于手术方案的制定尤为重要。方法对本院148例因患腰椎间盘突出症行手术治疗的患者进行回顾性研究，并对其中4例（2．7％）合并典型马尾神经综合征的患者进行长期随访（5个月-9年，平均6．1年），随访内容主要包括二便功能及下肢放射性疼痛症状恢复情况。结果下肢放射性疼痛症状恢复较快，二便功能恢复较为缓慢。但经过数年的随访，全部4例患者二便功能基本恢复，生活能够自理，结果较满意。结论腰椎间盘突出症并发马尾神经综合征患者经手术减压后二便功能近期恢复不满意，经长期非手术治疗后能够有较满意的恢复情况。

Clinical research of lumbar disc herniation combined with cauda equina syndrome

Objective Once lumbar herniated discs combined cauda equina syndrome is diagnosed, early operative decompression is advocated, but it may not always restore the bladder function. In such cases, the judgment of bladder and sphincter functional recovery is quite useful in planning the management of these patients.Methods Retrospective study was taken in 148 patients with lumbar disc herniation underwent surgery operation. And 4 cases (2.7%) with typical cauda equina syndrome were followed up for a long term (5 months to 9 years, average 6.1 years). Certain characteristic findings were noted on patients'recovery of urination and abdominal function, and of lower extremity radiating pain.Results The recovery of lower extremity radiating pain was good, but the recovery of urination and abdominal function was very slow. After several years follow-up, all the 4 patients achieved almost normal urination and abdominal function with no major impairment of daily activities.Conclusion Decompression operation for the patients with lumbar herniated discs combined cauda equina syndrome has little satisfaction on the recovery of urination and abdominal function in the near future, but long-term conservative treatment can be more satisfied with the recovery.