Small Stephen A, Perron Andrew D, Brady William J
Department of Emergency Medicine, University of Virginia Health System, Charlottesville, 22908-0699, USA.
Am J Emerg Med. 2005 Mar;23(2):159-63. doi: 10.1016/j.ajem.2004.03.006.
Low back pain is an extremely common complaint encountered by emergency and primary care physicians. Although the majority of patients have uncomplicated benign presentations, there is a small subset who has a much more severe disease process called cauda equina syndrome, which entails acute compression of the nerve roots of the cauda equina. These patients usually present posttraumatically with the triad of saddle anesthesia, bowel or bladder dysfunction, and lower extremity weakness. Significant morbidity can result from delayed diagnosis and treatment; therefore, the emergency physician should remain aware of this potential orthopedic pitfall. This case report discusses the clinical presentation, diagnosis, and relevant treatment of cauda equina syndrome in the ED.
腰痛是急诊科医生和基层医疗医生极为常见的就诊主诉。虽然大多数患者表现为不复杂的良性症状，但有一小部分患者患有更为严重的疾病过程，即马尾综合征，这需要对马尾神经根进行急性减压。这些患者通常在受伤后出现鞍区感觉缺失、肠道或膀胱功能障碍以及下肢无力三联征。诊断和治疗延迟可能导致严重的发病率；因此，急诊医生应始终警惕这种潜在的骨科陷阱。本病例报告讨论了急诊科马尾综合征的临床表现、诊断和相关治疗。
