Buszek M C, Ellenberg M, Friedman P
Arch Phys Med Rehabil. 1985 Dec;66(12):825-6.
Although partial or complete cauda equina compromise due to lumbar stenosis is a recognized entity, cauda equina compromise due to sacral stenosis is extremely uncommon. We present a patient with a three-week history of right thigh and buttock pain who developed right scrotal and buttock numbness, urinary retention, and difficulty with bowel evacuation. The patient had diminished sensation to right buttock and anus pinprick with decreased anal sphincter tone and absent bulbocavernosus reflex. Lumbosacral spine films revealed only minimal degenerative changes, while lumbar myelogram showed L4-L5 and L5-S1 ventral extradural defects. Only a drop of pantopaque descended caudally below the level of the L5-S1 interspace. Operatively, significant stenosis and thickening of the posterior sacrum with compromise of the lower sacral nerve roots was noted. Bilateral sacral laminectomy was performed and the symptoms resolved postoperatively. This case illustrates an unusual clinical entity: partial cauda equina compromise due to sacral stenosis.
虽然因腰椎管狭窄导致的部分或完全马尾神经受压是一种公认的病症，但因骶管狭窄导致的马尾神经受压极为罕见。我们报告一名患者，有三周的右大腿和臀部疼痛病史，随后出现右阴囊和臀部麻木、尿潴留及排便困难。患者右臀部和肛门针刺觉减退，肛门括约肌张力降低，球海绵体反射消失。腰骶部脊柱X线片仅显示轻微的退行性改变，而腰椎脊髓造影显示L4-L5和L5-S1腹侧硬膜外缺损。只有一滴碘苯酯尾侧下行至L5-S1间隙水平以下。手术中，发现骶骨后部明显狭窄和增厚，低位骶神经根受压。行双侧骶椎板切除术，术后症状缓解。该病例说明了一种不常见的临床病症：因骶管狭窄导致的部分马尾神经受压。
