Bel ağrısında acil bir durum: kauda equina sendromu ile kendini gösteren lomber disk hernisi
Date
2008-01-21
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Lomber disk herniasyonları nedeni ile ortaya çıkan kauda ekuina sendromu (KES) nadir görülür ve kesin cerrahi tedavi gerektirir. KES bulguları ile başvuran lomber disk herniasyonu olan 10 olgu retrospektif olarak incelendi. 8’i kadın, 2’si erkek ve yaş ortalamaları 52.4±11.8 yıldı. Major semptom şiddetli bel ve/veya bacak ağrısıydı. Hastalar acil operasyona alındı. Ortalama takip süresi 2,65 ±0,9 yıl idi. Semptomların başlamasından ilk 48 saat içinde operasyona alınan 5 olgunun 4’ünde (%80) idrar inkontinansı, 3’ünde (%60) perianal his kusuru tamamen düzeldi. 4 olgunun 3’ünde (%75) kuvvet kaybı ve bir olgunun seksüel disfonksiyonu tamamen düzeldi. 48 sonra operasyona alınan 5 olgunun 3’ünde (%60) idrar inkontinansında iyileşme olmadı. Seksüel disfonksiyon olan 1 olguda da düzelme gözlenmedi. Cerrahi alınma süresi tartışmalı olsa da, 48 saat içinde cerrahi dekompresyon yapılan olgularda duyu, motor ve üriner fonksiyonlarda belirgin iyileşme olmaktadır.
Cauda equina syndrome (CES) as a result of lumbar disc herniation is a rare entity and surgical treatment is mandatory. Ten patients with lomber disc herniation who were presented with CES symptoms were reviewed retrospectively. There were 8 female and 2 male patients with a mean age of 52.4±11.8. The major symptom was severe back and leg pain. All patients were operated on urgently. The mean follow-up were 2.65±0.9 years. Of 5 patients who were operated within 48 hours of onset of the symptoms, a significant improvement occured in 4 (80%) patients with urine retantion and in 3 (60%) patients with perianal hypoestesia. Three of the four patients had recovery of motor deficits, and also full recovery of the sexual dysfunction in one patient. Five patients were operated on after 48 hours. There were no improvement of the urinary dysfunction of 3 patients and the sexual dysfunction in one patient. Although the matter of the timing of surgery remains controversial, a significant improvement in sensory and motor deficits as well as urinary function occurred in patients who underwent decompression within 48 hours.
Cauda equina syndrome (CES) as a result of lumbar disc herniation is a rare entity and surgical treatment is mandatory. Ten patients with lomber disc herniation who were presented with CES symptoms were reviewed retrospectively. There were 8 female and 2 male patients with a mean age of 52.4±11.8. The major symptom was severe back and leg pain. All patients were operated on urgently. The mean follow-up were 2.65±0.9 years. Of 5 patients who were operated within 48 hours of onset of the symptoms, a significant improvement occured in 4 (80%) patients with urine retantion and in 3 (60%) patients with perianal hypoestesia. Three of the four patients had recovery of motor deficits, and also full recovery of the sexual dysfunction in one patient. Five patients were operated on after 48 hours. There were no improvement of the urinary dysfunction of 3 patients and the sexual dysfunction in one patient. Although the matter of the timing of surgery remains controversial, a significant improvement in sensory and motor deficits as well as urinary function occurred in patients who underwent decompression within 48 hours.
Description
Keywords
Kauda equina sendromu, Lomber disk herniyasyon, İdrar retansiyonu, Cauda equina syndrome, Lomber disc herniation, Urinary retantion
Citation
Doğan, Ş. vd. (2007). "Bel ağrısında acil bir durum: kauda equina sendromu ile kendini gösteren lomber disk hernisi". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 33(3), 141-144.