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严重腰椎管狭窄症患者骶管硬膜外注射后出现马尾综合征：病例报告

Cauda equina syndrome after caudal epidural sacral injection in severe lumbar spinal stenosis: Case report.

作者信息

Wibowo Hastomo Agung, Rhatomy Sholahuddin

机构信息

Orthopaedic Traumatology Department, Soeradji Tirtonegoro General Hospital, Indonesia; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia.

Orthopaedic Traumatology Department, Soeradji Tirtonegoro General Hospital, Indonesia; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia.

出版信息

Int J Surg Case Rep. 2020;77:12-14. doi: 10.1016/j.ijscr.2020.10.100. Epub 2020 Oct 25.

DOI:10.1016/j.ijscr.2020.10.100
PMID:33137663
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7610032/
Abstract

INTRODUCTION

Caudal epidural sacral injection is one of the most common conservative treatments for chronic low back pain with radiculopathy. Neurological deficit after injection is a rare complication that must be identified and treated properly.

PRESENTATION OF CASE

We report a case of cauda equina syndrome that persisted until 3 months after injection. A 63-year-old man came to our department with severe lumbar canal stenosis who experienced motor weakness, buttocks numbness and voiding difficulties immediately after injection. His lower extremities improved after 24 h, but his neurogenic bladder problems and perianal numbness still persisted. We collaborated with our interdisciplinary teams to do a rehabilitation program, and the symptoms were alleviated and he fully recovered within three months.

CONCLUSION

Patients with severe stenosis can be best described from magnetic resonance imagery scans, and clinicians should be careful about the risks after injection ranging from transient complications to persistent spinal cord injury.

摘要

引言

骶管硬膜外注射是慢性下腰痛伴神经根病最常见的保守治疗方法之一。注射后神经功能缺损是一种罕见的并发症，必须正确识别并治疗。

病例介绍

我们报告一例马尾综合征持续至注射后3个月的病例。一名63岁男性因严重腰椎管狭窄前来我院就诊，注射后立即出现运动无力、臀部麻木和排尿困难。24小时后其下肢症状有所改善，但神经源性膀胱问题和肛周麻木仍持续存在。我们与多学科团队合作开展康复计划，症状得到缓解，患者在三个月内完全康复。

结论

严重狭窄患者可通过磁共振成像扫描进行最佳描述，临床医生应注意注射后从短暂并发症到持续性脊髓损伤的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9030/7610032/9bc0ba8a8280/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9030/7610032/9bc0ba8a8280/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9030/7610032/9bc0ba8a8280/gr1.jpg

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