Department of Spine Surgery, Università Cattolica S. Cuore, Roma, Italy.
Eur Spine J. 2011 May;20 Suppl 1(Suppl 1):S128-31. doi: 10.1007/s00586-011-1745-2. Epub 2011 Mar 15.
Cauda equina syndrome seems to be a very rare complication of spinal manipulations. Only few cases, in fact, were referred in literature in the past decades. Most of them are very old and poorly documented evoking doubts about the pathogenetic relationship between the spinal maneuvers and the onset of the syndrome. We observed and treated a 42-year-old patient who complained a rapid onset of saddle hypoparesthesia and urine retention only a few hours after the spinal manipulation performed for L5-S1 herniated disc. The comparison of the two following MRIs performed before and after the manipulations seems to prove a close pathogenetic relationship. The patient was operated soon after the admission to our emergency department and 1 year later he referred an incomplete recovery of the syndrome. The case offered the opportunity to update the literature. The review revealed only three cases from the beginning of the current century that confirm the rarity of the syndrome. Based on the data emerging from the official literature, safety of the manipulations and its pathogenetic aspects in causing lumbar radiculopathies are discussed.
马尾综合征似乎是脊柱推拿的一种非常罕见的并发症。事实上，在过去几十年的文献中仅报道了少数几例。其中大多数都非常陈旧且记录不佳，这让人对脊柱手法与综合征发病之间的发病机制关系产生了怀疑。我们观察和治疗了一位 42 岁的患者，他在 L5-S1 椎间盘突出症进行脊柱推拿后仅数小时就出现了鞍区感觉减退和尿潴留的快速发作。在手法前后进行的两次 MRI 对比似乎证明了两者之间存在密切的发病关系。患者在入住我们的急诊室后不久就接受了手术，1 年后他报告说综合征仍未完全恢复。该病例为更新文献提供了机会。综述仅发现了本世纪初的 3 例病例，证实了该综合征的罕见性。基于官方文献中出现的数据，讨论了脊柱推拿的安全性及其在引起腰椎神经根病方面的发病机制。
