腰椎间盘突出症继发严重马尾神经综合征术后康复因素分析

目的研究腰椎间盘突出症继发马尾神经综合征的发病机制,探讨其治疗和预防措施。方法通过回顾腰椎间盘突出症合并马尾神经损伤24例患者的情况,对其发病原因、手术方法和随访结果进行了全面分析。所有病例均采用全椎板切除+椎间盘髓核摘除术。结果24例经手术治疗后随访结果按完全恢复、部分恢复、不恢复3种方式进行分类,其中运动功能恢复较好,括约肌功能障碍次之,鞍区感觉恢复最慢,性功能恢复最差。结论马尾神经综合征是腰椎间盘突出症的严重并发症,早期手术是治疗的关键,恢复程度与马尾神经的原始损伤程度、手术时机的选择、手术方式的运用和手术中的操作技术等因素密切相关。

Analysis of postoperative rehabilitation factors on lumbar disc herniation complicated with serious cauda equina syndrome

Aim The goal of this study was to investigate the mechanisms of secondary cauda equina syndrome (CES), a serious complication of lumbar disc herniation (LDH), and to provide a clue of the therapeutic methods and prevention measures. Methods In the retrospective study, 24 cases, who suffered from LDH complicating with CES, were evaluated in regards to etiology, surgical and post operative results. All the cases were operated with total laminectomy together with discoidectomy. Results 24 cases in the follow up, post operative period were analyzed for full, partial and no recovery. Among them, the motor function recovered fully, the disturbance of sphincter recovered partially, the sensory disturbance of sella area recovered partially, and sexual function recovered poorly. Conclusion CES is a serious complication of LDH, and early operation is the key of the treatment. There are some factors, including the degree