整形外科と災害外科
Online ISSN : 1349-4333
Print ISSN : 0037-1033
ISSN-L : 0037-1033
排尿障害を呈した腰椎椎間板ヘルニアの検討
坂本 昭夫小山 正信黒瀬 眞之輔甲斐 之尋高岡 徳彦
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1996 年 45 巻 1 号 p. 127-130

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Bladder dysfunction is rare, but needs urgent diagnosis and surgical treatment. At our hospital 129 cases were operated on for lumbar disc herniation over a period of two years (1993-1994) and subjects fell into two groups. Group A patients (125 cases) did not have bladder dysfunction, and Group B patients (4 cases) did. In Group B risk factors assouated with bladder dysfunction were obesity, history of lumbar ache, giant prolapsed herniation and acute worsening. Group B cases were operated on within 2 weeks (fastest 16 hours, longest 9 days since symptons occurred). Bladder dysfunction improved in all group B patients after sargery. Those operated upon sooner gained better recovery of bladder dysfunction except case 1 who had their operation the quickest, but had a poorer recovery for compared to the others. Case 1 had their prolapse at the disc between L3 and L4. The upper lumbar vertebral canal is narrow than lower, so it seems that symptoms occur more severely there. We evaluated bladder dysfunction using urinary velocity which the patient recorded. Urinary velocity was determined having patients record volume of urine over 24 hours as well as the time from start to finish of each urination.

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