What causes cauda equina nerve damage?

The first type belongs to patients with developmental lumbar spinal stenosis, which is mainly hypochondlasia, neuropathic compression syndrome caused by hypertrophy of lumbar lamina or ligamentum flavum, and nerve compression caused by dentival stenosis.

The second is mandatory spondylitis, which is more common in the lumbar spondylosis series, and patients in the early and middle stages are generally rarely accompanied by neurological comorbidities, but in the late stage, it is easy to be combined with cauda equina nerve damage.

The third is lumbar degenerative dislocation or burst fracture of the lumbar vertebrae, which is also the most unexpected patient at present, and it is also the most likely part of the patients who are directly aggravated by the condition

Lumbar degeneration and spondylolisthesis can cause spinal stenosis, and thickening of the ligamentum flavum on the lower edge of the lamina, which attaches to the lax lamina. It surrounds the dural sac, and the tissues in the lateral crypt compress the cauda equina nerve, causing many symptoms;

Some patients are often massaged, and massage will also cause spondylolisthesis resulting in cauda equina nerve compression or lumbar degenerative dislocation and lumbar fracture, which will lead to cauda equina nerve injury;

After vertebral or adnexal fractures, the fragments can pass through the dura and cause direct injury to the cauda equina nerve, hemorrhage, scarring, or even deeper injury to the conus equina or spinal cord. Vertebral compression fractures constitute a fold in the soft tissues of the spinal canal, and the spinal canal is extremely narrow, resulting in very severe or irreversible cauda equina nerve damage;

Accidental injury caused by firearms, this kind of firearm injury is a theory of injury caused by direct or indirect violent action, mostly seen in bullets or bullet fragments ingested into the spinal canal or vertebral ponto, a series of inflammatory reactions occur within a certain period of time, fibrous tissue proliferation, followed by scarring, and the cauda equina nerve will accumulate for a long time, resulting in gradually aggravating secondary damage;

Bleeding inside the body, such as traces of dural sac compression and a mass in the spinal canal, which is found to be active bleeding by angiography, and hematoma compresses the cauda equina nerve and causes damage to the cauda equina nerve;

The use of anesthetics, the epidural anesthetic needle is mistakenly inserted into the subarachnoid space, which directly injures the cauda equina nerve, causing edema or adhesion; Or the needle accidentally injures the epidural choroid plexus to form an epidural hematoma that compresses the cauda equina nerve, and the toxic effect of the anesthetic directly damages the nerve in the body.

In general, cauda equina nerve injury is common**, from lumbar disc herniation compressing the cauda equina nerve, and various reasons leading to lumbar spinal stenosis, thereby compressing cauda equina, as well as lumbosacral fracture, dislocation, or postoperative cauda equina injury, spinal epidural hematoma, schwannoma, and ependymoma, astrocytoma and other compression, can also cause cauda equina syndrome.

Developmental lumbar spinal stenosis is mandatory spondylitis, lumbar degenerative dislocation or burst fracture of lumbar spine, lumbar degeneration and spondylolisthesis can cause spinal stenosis, some patients are often massaged, massage can also cause spondylolisthesis resulting in cauda equina nerve compression or lumbar degenerative dislocation and lumbar fracture, these accidents will cause cauda equina nerve damage; After vertebral or adnexal fractures, the fracture fragments can pass through the dura and cause direct injury to the cauda equina nerve, hemorrhage, scarring, or even deeper injuries to the conus or spinal cord, accidental injuries caused by firearms.

Causes of cauda equina nerve injury:

1. Lumbar disc herniation.

Cauda equina syndrome due to lumbar disc herniation is a serious complication that can cause significant physical and mental disability. When the cauda equina is compressed by a large herniated disc or dead bone, acute or nonacute sensory impairment of the lower leg may occur with decreased sensitivity, urodynamics, and dysfunction of the urinary and sphincter muscles.

2. Lumbar spinal stenosis.

Lumbar spinal stenosis is the main causative element of cauda equina syndrome and is the most common form of intermittent claudication. In addition to idiopathic or achondroplasia lumbar spinal stenosis, the most common clinical conditions are acquired and secondary lumbar spinal stenosis, such as ankylosing spondylitis. Cauda equina nerve injury consists of injury to the cauda equina nerve itself and cauda equina compression injury caused by lumbar spinal stenosis, and may have characteristic movement disorders - intermittent neurogenic claudication.

Symptoms due to lumbar spinal stenosis or cauda equina syndrome are considered absolute indications for surgery, and adequate decompression is recommended while maintaining or restoring segmental stability.

3. Lumbosacral vertebra fracture and dislocation.

Cauda equina syndrome can be caused by fracture and dislocation of the lumbosacral vertebrae, manual massage, or post-traumatic lesions.

4. Cauda equina syndrome occurs after lumbosacral spine surgery.

Partial or complete cauda equina syndrome after lumbar spine surgery is a disease that requires urgent treatment, especially when the condition is progressively worsening, emergency imaging examination is required, and if the imaging is clear about lumpy-like lesions, emergency surgical exploration is required. Causes may be related to inadequate decompression, nerve root swelling, hematoma, residual disc fragments, gelatin sponges, intradural masses, or adipose tissue or vascular insufficiency implanted in the spinal canal (poor blood supply to the cauda equina).

5. Cauda equina syndrome caused by spinal epidural hematoma.

Cauda equina syndrome caused by spinal epidural hematoma is associated with trauma, anticoagulation**, vascular abnormalities, and postoperative hematoma. One. Once suspected, appropriate imaging examinations should be performed as soon as possible, and the hematoma should be removed as soon as possible after diagnosis, except for the primary disease, because epidural hematoma can cause significant spinal cord and cauda equina compressive injury.

Prognosis is closely related to the severity of symptoms, the number of segments injured, and the timing of surgery.

Common cauda equina nerve injuries include lumbar spinal stenosis, ankylosing spondylitis, lumbar degenerative changes, lumbar burst fractures, and injuries caused by external forces in firearm accidents. Traditional Chinese medicine mostly belongs to the loss of liver and kidney, the weakness of the spleen and stomach, and the blockage of the meridians, resulting in the internal movement of the liver and wind.

Lumbar disc fragmentation, herniation, lumbar muscle strain, sports injury, fall, car accident, pregnancy, spinal fracture, muscle tear, spinal stenosis, tumor compression, infection or bleeding, etc.

Lumbar intervertebral disc fragmentation, herniation, lumbar muscle strain, sports injury, fall, car accident, pregnancy, spinal fracture, spinal stenosis, tumor compression, etc.

Huge lumbar disc herniation, lumbar vertebrae blowout fracture causes bone fragments to directly damage nerves, and cysts and tumors grow in the body.

Lumbar spinal stenosis: As the name suggests, it is the spinal stenosis that accommodates the cauda equina nerve, and due to various reasons, the spinal canal is compressed by pressure to produce cauda equina syndrome.

Ankylosing spondylitis: It is a disease of the spine and joints mainly affected by the axial joints, and is a chronic disease. Fibrosis and ossification of the sacroiliac joints, fibrous annulus and nearby connective tissue can also lead to cauda equina nerve injury due to inflammation from this disease.

Ankylosing spondylitis is an inflammatory rheumatic disease that can cause damage to the cauda equina nerve.

Abscess infection: an abscess-like spinal canal infection, such as osteomyelitis, develops outside the lumbar dural sac, which may potentially compress the spinal canal, causing neurological symptoms that can lead to cauda equina syndrome.

Tumors: Tumors near the spine may compress the spinal canal, and tumors may originate in the spine, but the more common cancers in the body (referred to as nausea tumors) will spread to the periphery of the spine, and it is easy to cause compression damage to the cauda equina nerve root.

Trauma: Injuries to the lumbar spine, such as car accidents, falls, penetrating injuries (gunshot wounds or knife wounds), etc., may directly damage the cauda equina nerve, leading to complications, or even more serious consequences due to the large area.

Surgical sequelae: common complications after various lumbar spine surgeries, many patients report that after surgery** lumbar disc herniation will experience cauda equina syndrome, due to violent surgery or unskilled or unavoidable operation resulting in varying degrees of nerve damage and cauda equina syndrome.

There are many factors that cause cauda equina nerve damage, such as congenital lumbar spinal stenosis, lumbar disc herniation, inflammation such as ankylosing spondylitis, surgery, life accidents, etc., which may cause damage.

In general, cauda equina nerve injury is common**, from lumbar disc herniation compressing the cauda equina nerve, and various reasons leading to lumbar spinal stenosis, thereby compressing cauda equina, as well as lumbosacral fracture, dislocation, or postoperative cauda equina injury, spinal epidural hematoma, schwannoma, and ependymoma, astrocytoma and other compression, can also cause cauda equina syndrome.

At present, in clinical medicine, such as lumbar burst fracture, lumbar degeneration or cholesteatoma around cauda equina, schwannoma, spinal meningioma, lipoma, etc., may cause damage to the cauda equina nerve, as well as patients with severe lumbar disc herniation, patients with spinal canal cysts, patients with hysteria after surgery, car accidents, falls and other patients, in many cases, the cauda equina nerve may be compressed or damaged.

There are many causes of cauda equina nerve injury, such as congenital lumbar spinal stenosis, lumbar disc herniation, ankylosing spondylitis and other inflammations, life accidents such as falls from heights, car accidents, etc.

When cauda equina nerve injury occurs, it is often easy to manifest as obvious discomfort symptoms at the bottom of the patient's saddle or even incontinence, so it is recommended to choose surgical exploration or neurolysis when surgery is indicated in the acute stage, which can help patients relieve symptoms and improve their condition.

In the absence of surgical guidelines, it is recommended to give the patient intravenous drip to nourish the nerves** to help correct the state of nerve ischemia and hypoxia. In addition, patients can also be appropriately given some simple physical **, such as massage, massage, physiotherapy, etc.

Fracture dislocation below the 2nd lumbar vertebra can cause cauda equina injury. Complete rupture of the cauda equina is rare and can result in sensory-motor reflexes below the level of injury Bladder weakness. If the cauda equina is completely broken, or sutures are performed after the fracture, complete or partial function can be restored through nerve regeneration.