Aresti Nick, Murugachandran Govin, Shetty Rohit
Department of Trauma and Orthopaedics, The Whittington Hospital, Archway, London, United Kingdom.
J Orthop Surg (Hong Kong). 2012 Aug;20(2):250-3. doi: 10.1177/230949901202000224.
We report 3 patients with cauda equina syndrome (CES) secondary to a sacral fracture. The difficulty in early diagnosis of CES and the lack of evidence and guidance on treatment are highlighted. When there is a sacral fracture, CES should be suspected. Thorough clinical examination including digital rectal examinations and bladder function quantification is advised. The threshold for performing computed tomography and/or magnetic resonance imaging of the pelvis should be low. Patients should be treated by a multi-disciplinary team with both orthopaedic and neurosurgical input. Further studies are needed to identify the timing and to which patients surgical decompression should be performed.
我们报告了3例因骶骨骨折继发马尾神经综合征（CES）的患者。强调了CES早期诊断的困难以及治疗方面缺乏证据和指导。当存在骶骨骨折时，应怀疑有CES。建议进行全面的临床检查，包括直肠指检和膀胱功能量化。骨盆计算机断层扫描和/或磁共振成像的检查门槛应较低。患者应由包括骨科和神经外科医生在内的多学科团队进行治疗。需要进一步研究以确定手术减压的时机以及应针对哪些患者进行手术减压。
