馬尾神経圧迫型ヘルニアの臨床的検討

抄録

Cauda equina lesions due to lumbar disc prolapse are very rare. We have experienced nine patients with cauda signs out of eight hundred thirty six operated on lumbar disc lesions. The incidence was 1.1 percent. The clinical investigation of nine patients were as follows:
a) The levels of the disc prolapse in these nines were one with lumbar 3/4 disc prolapse, six with lumbar 4/5 disc prolase and two with lumbar 5/sacrar prolapse, frequencies of these levels were the same pattern as those without cauda equina signs.
b) Motor and sensory changes (root sign) were different from prolapsed level in seven among nine patients.
c) Operative procedures were performed by laminectomy and disc removal in eight and anterior interbody fusion in one. They were usually operated on by posterior decompression.
d) Results of follow-up were good (one) and excellent (seven) and these all patients returned to primary occupation except one fair patient with S. L. B.
e) Grade and duration of paralysis have an important influence upon the prognosis, so without regard to the grade of paralysis, immediate operation (emergency operation) brings on excellent prognosis.