目的:为了确定频率,临床表现,马尾综合征(CES)的病因。
方法:这项回顾性研究对256名参与者进行,目的分析CES疑似病例的临床表现频率和模式。纳入标准包括18岁或以上的参与者,他们有医疗记录可供审查,并有CES的红色标志症状。该研究收集了有关各种因素的信息,例如年龄,性别,在MRI上确认CES,神经功能缺损,病因因素,症状持续时间,还有更多.使用描述性统计和逻辑回归分析收集的数据,以确定MRI证明的CES和可疑CES之间的重要变量。
结果:平均年龄为58.05±19.26岁,女性151人(58.98%),男性105人(41.02%)。大多数(50.78%)患有神经功能缺损,而其他症状包括排尿困难或尿流感觉受损(17.58%),直肠饱胀感丧失(3.12%),尿失禁或大便失禁(35.16%),双侧坐骨神经痛(21.88%),下肢神经症状(25.00%),麻醉或任何腿部无力(24.22%),以双侧坐骨神经痛为主要症状(21.88%)。症状为慢性的占47.27%,急性的占21.88%。经MRI证实的CES的机率每年增加3%。神经功能缺损与MRI证实的CES密切相关(OR=14.97),而直肠饱胀感的丧失使几率增加了10倍(OR=10.62)。
结论:CES可以出现各种症状,包括双侧神经功能缺损,尿失禁和大便失禁,和双侧坐骨神经痛,随着年龄,严重的双侧神经功能缺损,直肠饱胀感的丧失与MRI证实的CES有关。早期诊断和治疗对于更好的结果至关重要。
OBJECTIVE: To determine the frequency, clinical presentation, and etiological factors of cauda equina syndrome (CES).
METHODS: This retrospective
study was done on 256 participants, and aimed to analyze the frequency and patterns of clinical presentation in suspected cases of CES. The inclusion criteria included participants aged 18 or older with medical records available for review and having red-flagged symptoms for CES. The
study collected information on various factors such as age, gender, confirmation of CES on MRI, neurological deficits, etiological factors, duration of symptoms, and more. The data collected was analyzed using descriptive statistics and logistic regression to identify significant variables between MRI-proven CES and suspected CES.
RESULTS: The mean age was 58.05 ± 19.26 years, with 151 females (58.98%) and 105 males (41.02%). The majority (50.78%) had a neurological deficit, while other symptoms included difficulty initiating micturition or impaired sensation of urinary flow (17.58%), loss of sensation of rectal fullness (3.12%), urinary or faecal incontinence (35.16%), bilateral sciatica (21.88%), neurological symptoms in the lower limbs (25.00%), anaesthesia or any leg weakness (24.22%), and bilateral sciatica as the predominant symptom (21.88%). Symptoms were chronic in 47.27% and acute in 21.88%. The odds of MRI-proven CES increase by 3% per year of age. Neurological deficit was strongly associated with MRI-proven CES (OR = 14.97), while loss of sensation of rectal fullness increased the odds by 10-fold (OR = 10.62).
CONCLUSIONS: CES can present with various symptoms, including the bilateral neurological deficit, urinary and faecal incontinence, and bilateral sciatica, with age, severe bilateral neurological deficit, and loss of sensation of rectal fullness being associated with MRI-proven CES. Early diagnosis and treatment are crucial for better outcomes.