早期手术治疗腰椎间盘突出症伴马尾神经损伤  

Early surgery for cauda equina syndrome secondary to lumbar disc herniation

作　　者：谭俊铭[1] 史建刚[1] 袁文[1] 叶晓健[1] 何海龙[1] 史国栋[1] 贾连顺[1] 李家顺[1] 

机构地区：[1]上海长征医院骨科,上海200003

出　　处：《颈腰痛杂志》2007年第5期366-369,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨腰椎间盘突出症伴马尾神经损伤起病48小时内手术治疗的疗效。方法明确马尾综合征(CES)的22例患者行急诊经关节突内侧潜行椎板/半椎板切除减压手术且获随访。结果22例患者(男13例、女9例)的平均年龄为42.5岁(23～68岁),平均随访42个月(24～72个月),均在CES发生48小时内手术。术后6个月,除1例外,其他患者均获得显著的神经功能康复。结论CES发病48小时内手术,尤其术中高度重视根管的充分彻底减压,有助于CES患者的功能恢复。Objective To determine the therapeutic effect after operation on within 48 hours of onset of cauda equina syndrome （CES）following lumbar disc herniation. Methods Twenty-two patients with evidences of cauda equina syndrome who underwent urgent surgery by laminectomy/ hemilaminectomy with partial undercutting facetectomy were identified and invited to follow-up＋ Results Twenty-two patients attended with a mean follow-up of 42 months（range,24-72 months）. Mean age at onset were 42.5 years （range,23-68 years）with 13 males and 9 females. All patients were operated on within 48 hours of onset of cauda equina syndrome following lumbar disc herniation,and either partial CES or complete CES showed significantly neurological improvements by 6 months at follow-up except one patient. Conclusion Patients should undergo surgery as soon as possible within 48 hours after onset of the syndrome and nerve root canal should be thoroughly decompressed with partial undercutting facetectomy.

关 键 词：马尾综合征 腰椎间盘 手术 减压 结果 

分 类 号：R681.53[医药卫生—骨科学]