Ammar Adam, Zarnegar Reza, Yassari Reza, Kinon Merritt
Department of Neurosurgery, Montefiore Medical Center, New York, USA.
Department of Neurology, Weill Cornell Medical College, New York Presbyterian Queens Hospital, New York, USA.
Surg Neurol Int. 2018 Mar 19;9:66. doi: 10.4103/sni.sni_482_17. eCollection 2018.
Few studies in the literature discuss operative positioning for lumbar surgery precipitating acute cauda equina syndromes (CES).
A 56-year-old male with a large L2-3-disc herniation was placed prone on a Jackson table. He immediately lost all motor and sensory evoked potentials. Signals returned to the baseline when surgery was aborted, and he was returned to the supine position. However, potentials were again lost when he was repositioned prone, following which the surgeons proceeded with surgical decompression with a good outcome.
This case highlights the risk for patients with large acute lumbar disc herniation/stenosis and CES undergoing prone positioning for lumbar decompression. Here, despite the secondary loss of both sensory and motor evoked potentials, the patient successfully underwent lumbar decompressive surgery/discectomy performed on a Jackson table, resulting in full postoperative neurological recovery.
文献中很少有研究讨论腰椎手术的手术体位引发急性马尾综合征（CES）的情况。
一名患有巨大L2-3椎间盘突出症的56岁男性俯卧在杰克逊手术台上。他立即失去了所有运动和感觉诱发电位。当手术中止且他被恢复到仰卧位时，信号恢复到基线水平。然而，当他再次被重新置于俯卧位时，电位再次消失，随后外科医生进行了手术减压，结果良好。
该病例突出了患有巨大急性腰椎间盘突出症/狭窄症和CES的患者在接受腰椎减压俯卧位手术时的风险。在此病例中，尽管感觉和运动诱发电位均出现继发性丧失，但患者在杰克逊手术台上成功接受了腰椎减压手术/椎间盘切除术，术后神经功能完全恢复。
