摘要
目的:探讨腰椎手术中无明确原因的迟发性脊神经及马尾损伤的原因及其预防和治疗措施。方法:回顾性分析2006年4月至2008年4月650例腰椎手术患者中4例术中脊神经损伤的病例资料,分析术后出现脊神经及马尾损伤的原因,探讨治疗和预防的方法。结果:4例患者均为术后12 h后出现不同程度的脊神经及马尾损伤症状,发现后均立即行手术探查,术中并未发现肉眼所见神经切割、手术器械机械压迫、血肿压迫及断裂等损伤。治疗上主要是激素、脱水、营养神经、针灸和理疗等,治疗1个月,4例患者症状无明显缓解,出院后继续加强康复功能锻炼,双下肢感觉、运动功能逐渐恢复,半年后生活完全自理,基本恢复正常,仅遗留足部轻微麻木感。结论:术中过度牵拉是造成脊神经及马尾损伤的重要原因;神经损伤后应该积极主动地治疗,早期治疗及功能康复锻炼在脊神经损伤病人恢复过程中发挥了重要作用。
Objective： To analyze the causes and explore the prevention and treatment strategies of spinal nerve and cauda equine injuries in lumbar surgery.Methods： Retrospective study involving 4 of 650 patients undergoing lumbar operation who had admitted to our hospital from April 2006 to April 2008 was conducted.The causes of nerve injury after operation were analyzed and the prevention and treatment strategies were investigated.Results： All four cases developed clinical manifestation of nerve and cauda equina injury 12 hours after the operation and immediate exploratory operation was conducted.No direct injury of rupture,equipment compression and hematoma compression was found.After one month of treatment including adrenal cortex hormone,treatment of neurotrophic and physical therapy,the sensory and motor function of lower limb recovery gradually and return to self-care about half a year later.Conclusion： Excessive drag is the main cause of nerve and cauda equina injury and careful handling is the key point to prevent the happening of injury.Function rehabilitation play a key role in the recovery of nerve injury.
出处
《现代医学》
2011年第3期336-339,共4页
Modern Medical Journal
关键词
腰椎手术
脊神经损伤
马尾损伤
lumbar surgery
spinal nerve injuries
cauda equina injury
