Br J Hosp Med (Lond). 2023 Dec 5;84(11):1-7. doi: 10.12968/hmed.2023.0012.
Cauda equina syndrome is an uncommon but serious cause of lower back pain resulting from compression of the cauda equina nerve roots, most commonly by lumbar disc herniation. Red flag symptoms, such as bladder dysfunction, saddle anaesthesia and sciatica, should lead to high clinical suspicion of cauda equina syndrome. The British Association of Spinal Surgeons has published an updated standard of care for these patients because of the potentially debilitating effects of missed cases of cauda equina syndrome. This review summarises these standards and provides a framework to support quick triage of at-risk patients. Immediate magnetic resonance imaging, within 1 hour of presentation to the emergency department, is crucial in patients with suspected cauda equina syndrome to allow prompt diagnosis and treatment. Urgent decompressive surgery is usually recommended for the best outcomes, to reduce morbidity and complication rates.
马尾综合征是一种罕见但严重的下腰痛病因，由马尾神经根受压引起，最常见的原因是腰椎间盘突出症。应高度怀疑马尾综合征的存在，尤其是存在膀胱功能障碍、鞍区感觉麻木和坐骨神经痛等“红旗”症状。由于漏诊马尾综合征可能导致严重后果，英国脊柱外科医师协会发布了该类患者的最新诊疗标准。本文总结了这些标准，并为高危患者的快速分诊提供了框架。对于疑似马尾综合征的患者，在急诊科就诊后 1 小时内进行立即磁共振成像检查至关重要，这有助于及时诊断和治疗。为了获得最佳效果，通常建议进行紧急减压手术，以降低发病率和并发症发生率。
