McLaren A C, Bailey S I
Clin Orthop Relat Res. 1986 Mar(204):143-9.
Six cases of acute postdiscectomy cauda equina syndrome (C.E.S.) following lumbar discectomy were reviewed retrospectively in a series of 2842 lumbar discectomies over a ten-year period. Five cases had coexisting bony spinal stenosis at the level of the disc protrusion. The bony spinal stenosis was not decompressed at the time of discectomy. Inadequate decompression played a role in the neurologic deterioration postoperation. The cause of the sixth case is unknown. Bowel and bladder recovery was good when the cauda equina decompressed early; sensory recovery was universally good, and motor recovery was poor if a severe deficit had developed before decompression. Careful review of the preoperative myelogram to rule out spinal stenosis and decompression of bony stenosis at discectomy are recommended for prevention of postoperative C.E.S. Urgent decompression of postoperative C.E.S. is advisable if compression of the cauda equina is confirmed radiographically.
回顾性分析了在十年期间进行的2842例腰椎间盘切除术中出现的6例急性椎间盘切除术后马尾神经综合征（C.E.S.）。5例在椎间盘突出水平存在合并的骨性椎管狭窄。在椎间盘切除术时未对骨性椎管狭窄进行减压。减压不充分在术后神经功能恶化中起了作用。第6例的病因不明。当马尾神经早期减压时，肠道和膀胱功能恢复良好；感觉恢复普遍良好，如果在减压前已出现严重功能障碍，则运动恢复较差。建议仔细复查术前脊髓造影以排除椎管狭窄，并在椎间盘切除术时对骨性狭窄进行减压，以预防术后C.E.S.。如果经影像学证实存在马尾神经受压，术后C.E.S.应紧急减压。
