Igor Ján Šulla a kol.
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|Author:||Igor J. Šulla|
|Contributions:||Imrich Lukáč, Igor Šulla|
|Year of publication:||2019|
|Faculty:||Faculty of Medicine|
|Clinic:||Department of Neurosurgery|
Cauda equina syndrome caused by herniation of intervertebral disc sequesters (Ces-d) is a rare, but very serious complication of degenerative changes of verterbal column.
In a group of 57 women and 101 men operated on for Ces-d during 26 years authors tried to identify some factors potentially negatively influencing the outcome and results of the clinical trial correlated with findings in a canine experimental study. Results showed that restoration of senzitive, motir and vegetative innervation in patients was unsatisfactory. Negative factors were age over 30, compression of neural structures at the level of L4 disc, compression by a bulky mass of sequesters and duration of compression over 24 hours. Lightomicroscopic observations of 30 μm thick sections from L-S spinal cord segments of dogs following 9-day constrictions of cauda equina showed irreverisible changes of spinal cord neurons and tracts. Syndroma caudae equinae is a complex clinical entity accompanied by a damage of central nervous system structures. These facts imply the importance of prevention of Ces-d. If Ces-d occurs, only an emergent surgical decompression of lumboscral spinal nerve roots can avoid the development of a permanent deficit.