Singh Prakash, Batish V K, Sarup Sarv, Singh Amarjit, Singh A P
Classified Specialist (Neurosurgery), Command Hospital (NC), C/O 56 APO.
Classified Specialist (Neurosurgery), Base Hospital, Delhi Cantt - 10.
Med J Armed Forces India. 2000 Apr;56(2):117-121. doi: 10.1016/S0377-1237(17)30125-9. Epub 2017 Jun 10.
A retrospective analysis of 30 operated cases of prolapsed lumbar disc with cauda equina syndrome was carried out. 27 were male and 3 were female. Age varied from 27 to 60 years. 10 were acute presentation and 20 had previous history of backache-sciatica syndrome. The most common sphincter dysfunction was urinary retention and other neurological findings, pointing to sphincter involvement were impairment of sensation in the perineum, lax anal sphincter and absent superficial anal reflex. The other motor or sensory deficit depended on level of disc herniation. The majority of our patients reached us between 7-14 days after onset of sphincter dysfunction. Emergency myelogram was the most common investigation done and L 4/5 was most common disc herniation. Emergency surgery was done in 24 cases and semi emergency in 6 cases. Patients were followed up and at 1 year follow-up 12 had recovered fully, 7 partially and in rest 11 patients there was no significant improvement in sphincter functions.
对30例腰椎间盘突出症合并马尾神经综合征手术病例进行了回顾性分析。其中男性27例，女性3例。年龄在27至60岁之间。10例为急性发病，20例有腰痛-坐骨神经痛综合征病史。最常见的括约肌功能障碍是尿潴留，其他提示括约肌受累的神经学表现包括会阴部感觉减退、肛门括约肌松弛和肛门浅反射消失。其他运动或感觉缺陷取决于椎间盘突出的节段。大多数患者在括约肌功能障碍发作后7至14天前来就诊。紧急脊髓造影是最常见的检查方法，L 4/5椎间盘突出最为常见。24例行急诊手术，6例行半急诊手术。对患者进行了随访，在1年的随访中，12例完全康复，7例部分康复，其余11例患者的括约肌功能无明显改善。
