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Síndrome da cauda equina

  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源
最后审阅： 20 Aug 2025
最后更新： 06 Feb 2023

小结

定义

病史和体格检查

关键诊断因素

  • disfunção vesical
  • fraqueza nos membros inferiores
  • parestesia/anestesia em sela
  • disfunção intestinal
完整详情

其他诊断因素

  • lombalgia
  • ciática
  • disfunção sexual
完整详情

危险因素

  • hérnia de disco lombar
  • trauma espinhal
  • cirurgia da coluna vertebral
  • abscesso epidural espinhal
  • terapia anticoagulante
  • estenose da coluna vertebral
  • tumor da medula espinhal
  • menos de 50 anos de idade
完整详情

诊断性检查

首要检查

  • RNM da coluna lombar sem contraste IV
  • TC da coluna lombar sem contraste IV
完整详情

需考虑的检查

  • Mielotomografia da coluna lombar
  • teste urodinâmico
  • exame de toque retal
完整详情

治疗流程

急症处理

SCE confirmada

撰稿人

作者

Kenneth F. Casey, MD, FACS

Clinical Associate Professor

Neurosurgery

Michigan State University

Clinical Associate Professor

Physical Medicine and Rehabilitation

Wayne State University School of Medicine

Detroit

MI

利益声明

KFC declares that he has no competing interests.

同行评议者

Kevin Barraclough, MA, FRCP, FRCGP, LLB

GP

Painswick Surgery

Painswick

Gloucester

UK

利益声明

KB is an author of references cited in this topic. KB declares that he has no competing interests.

Louis Chang, MD

Assistant Professor of Neurological Surgery

Weill Cornell Medicine

New York

NY

利益声明

LC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Todd NV, Dickson RA. Standards of care in cauda equina syndrome. Br J Neurosurg. 2016 Oct;30(5):518-22. 摘要

Finucane LM, Downie A, Mercer C, et al. International framework for red flags for potential serious spinal pathologies. J Orthop Sports Phys Ther. 2020 Jul;50(7):350-72.全文  摘要

Expert Panel on Neurological Imaging., Hutchins TA, Peckham M, et al. ACR appropriateness criteria® low back pain: 2021 update. J Am Coll Radiol. 2021 Nov;18(11s):S361-79.全文  摘要

Germon T, Ahuja S, Casey ATH, et al. British Association of Spine Surgeons standards of care for cauda equina syndrome. Spine J. 2015 Mar 2;15(3 suppl):S2-4. 摘要

Chau AM, Xu LL, Pelzer NR, et al. Timing of surgical intervention in cauda equina syndrome: a systematic critical review. World Neurosurg. 2014 Mar-Apr;81(3-4):640-50.全文  摘要

Epstein NE. Review/perspective: operations for cauda equina syndromes - "The sooner the better". 2022 Mar 25;13:100.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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