腰椎间盘突出致马尾综合征的手术疗效分析  

Analysis on surgical outcomes of Cauda Equina Syndrome secondary to Lumbar Disc Herniation

作　　者：高苏宁[1] 陆晓哲[2] 赵红军[1] 杨书丰[1] 邱康宁[1] 段文江[1] 

机构地区：[1]解放军第81医院骨科,江苏南京210002 [2]解放军第81医院泌尿外科,江苏南京210002

出　　处：《东南国防医药》2009年第3期218-220,共3页Military Medical Journal of Southeast China

摘　　要：目的探讨腰椎间盘源性马尾综合征（CES）的损伤机制、病程特点、手术时机和疗效。方法对38例CES手术患者临床资料进行分析,术式包括：全椎板、大开窗、双侧扩大开窗。根据临床症状、体征,确定CES伤型,对CES患者的手术时间窗与疗效作评析。结果随访2-17年（平均3.4年）。手术时间：〈48 h组优良率73%,〉48 h组优良率56%;差6例,其中5例为术前完全瘫痪者。结论CES是腰椎间盘的严重并发症,要求及时诊断、早期手术。Objective To investigate the characteristics, mechanism, treatment effect of cauda equina syndrome （CES） secondary to lumbar disc herniation（HLD）. Methods 38 cases of CES secondary to HLD were reviewed. All the cases were treated with surgery including all laminectomy on 8 cases, center fenestration on 10 caces and bilateral fenestration on 20 cases. According to clinical symptoms and neurologic signs of cauda equina compression, incomplete or complete lesion of the cauda equina was identified and the relationship between surgical time and clinical outcomes were analyzed. Results The 38 patients were followed up for 2-17years, average of 3.4 years. The excellent and good rate in the less than 48-hour group of decompression were73% and in the more than 48-hour group were 56%. The cases with complete lesion of CES in these two groups were poor of surgical effect. The surgical effects were related with timeframe of decompression and the degree of damage to the canda equina. Conclusion As a severe neurlogic complications, early diagnosis and operative decompression are advocated in CES.

关 键 词：马尾综合征 腰椎间盘突出症 手术效果 

分 类 号：R681.53[医药卫生—骨科学]