Tarulli Andrew W
Continuum (Minneap Minn). 2015 Feb;21(1 Spinal Cord Disorders):146-58. doi: 10.1212/01.CON.0000461090.09736.45.
Cauda equina syndrome is an important neurologic disorder characterized by lower back pain, sciatica, perineal numbness, and sphincter dysfunction. This article reviews the anatomy, clinical presentation, evaluation, and treatment of cauda equina dysfunction, focusing on diskogenic cauda equina syndrome.
Assessment of suspected cauda equina syndrome is hampered by modest diagnostic accuracy of any one clinical feature. Although urgent operation for diskogenic cauda equina syndrome is standard practice, most data about timing of intervention comes from small case series; however, randomized trials are very unlikely given the ethical implications of delaying surgical intervention.
In the absence of high-quality data indicating otherwise, urgent evaluation and intervention are required for diskogenic cauda equina syndrome. Other etiologies of cauda equina dysfunction including neoplastic, infectious, and iatrogenic causes must also be considered, especially in the setting of normal neuroimaging studies.
马尾综合征是一种重要的神经系统疾病，其特征为下背部疼痛、坐骨神经痛、会阴麻木和括约肌功能障碍。本文回顾了马尾神经功能障碍的解剖结构、临床表现、评估及治疗，重点关注椎间盘源性马尾综合征。
任何一项临床特征的诊断准确性有限，这给疑似马尾综合征的评估带来了阻碍。虽然对椎间盘源性马尾综合征进行紧急手术是标准做法，但大多数关于干预时机的数据来自小型病例系列；然而，考虑到延迟手术干预的伦理问题，进行随机试验的可能性极小。
在缺乏高质量数据表明其他情况时，椎间盘源性马尾综合征需要进行紧急评估和干预。还必须考虑马尾神经功能障碍的其他病因，包括肿瘤性、感染性和医源性原因，尤其是在神经影像学检查正常的情况下。
