Das Cauda-Equina-Syndrom – Ein spinaler neurochirurgischer Notfall

Das Cauda-Equina-Syndrom (CES) ist ein Symptomkomplex aus Miktions-/Defäkationsstörungen, perinealen Sensibilitätsstörungen mit und ohne sexueller Dysfunktion – oft begleitet von Schmerzen und Paresen. Voraussetzung für die operative Therapie eines CES möglichst innerhalb eines medizinischen bzw. medicolegalen indizierten Zeitintervalls von 24 Stunden ist das Erkennen des Krankheitsbilds als spinaler Notfall und die Einleitung der notwendigen Diagnostik. Die Magnetresonanztomografie (MRT) ist die Diagnostik der Wahl. Ursächlich für ein CES sind am häufigsten lumbale Bandscheibenvorfälle. Die Prognose für die Rückbildung der Defizite hängt ab vom Zeitintervall zwischen Auftreten der Symptome und Therapie, aber auch von der Schwere der Symptomatik zum Zeitpunkt der Operation.

Cauda equina syndrome (CES) is defined as a combination of bladder/bowel dysfunction, perineal sensory disturbances or sexual dysfunction often associated with pain and motor deficits. Surgery for a CES within 24hours or sooner requires identification of so called ”red flag“ symptoms and the initiation of appropriate diagnostic means. MRI is the diagnostic method of choice. CES is most frequently caused by lumbar disc herniations. Prognosis for recovery depends on the time between onset of symptoms and surgery but also on the severity of symptoms at time of presentation.

Key words

Cauda equina syndrome - bladder/bowel dysfunction - perineal sensory disturbances - sexual dysfunction

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