Horsetail injury refers to
1. Compressive factors of bone structure variation: Developmental lumbar spinal stenosis, ankylosing spondylitis, lumbar degenerative tail or lumbar fracture may all cause cauda equina nerve injury.
2. Soft tissue compression factors: It is reported that CES caused by lumbar disc herniation is 5.4% ~ 10.6%, accounting for 9.3% of surgical treatment of lumbar disc herniation and lumbar spinal stenosis. Because lumbar disc herniation and lumbar spinal stenosis are common diseases, CES is more common. It has also been reported that the incidence of lumbar disc herniation with CES is about 7%. At the same time, the segments, location, degree and surgical prognosis of disc herniation are described in detail, and it is considered that disc herniation can be divided into acute and chronic. In acute protrusion, its protrusion not only compresses cauda equina, but also impacts cauda equina at the moment when cauda equina leaves spinal canal, aggravating cauda equina ischemia and edema and affecting normal cerebrospinal fluid circulation.
3. Firearm injury: Firearm injury is an injury caused by direct or indirect violence, which is common in wartime. It is emphasized that the injury of bone and soft tissue leads to the injury and repair of nerve tissue, and the main reasons of ces are that scar tissue wraps around ponytail to produce compression and chemical substances stimulate ponytail.
4. Hemorrhage: et al. studied the progressive CES caused by sacral canal aneurysm. According to the information provided by its symptoms and signs, the lesion is located in the lumbosacral region. MRI showed impression of dural sac and space occupying in spinal canal, angiography showed that the space occupying was active hemorrhage, and hematoma pressed cauda equina nerve to cause CES.
5. Spinal anesthesia: CES caused by spinal anesthesia has also been reported. Drasner and others have studied CES caused by epidural anesthesia, and think that there are three reasons at present: (1) The epidural anesthesia needle mistakenly enters the subarachnoid space, which directly damages the cauda equina, causing edema and adhesion of cauda equina; (2) Acupuncture accidentally injures the epidural choroid plexus to form an epidural hematoma, which compresses the cauda equina; (3) Toxic effects of anesthetics. Such reports are not uncommon.
6. Chemicals: Some people use intervertebral space injection of discolytic enzyme to treat ces caused by disc herniation. Samuel et al. analyzed 3 cases, of which 1 case was caused by this method. The other 2 cases had severe CES. The reason may be that lysozyme causes incomplete dissolution of intervertebral disc, forms intervertebral disc fragments, enters the spinal canal, and causes compression of cauda equina. It may also be arachnoid inflammation caused by lysozyme entering subarachnoid space by mistake, and the degree of this lesion is directly proportional to the severity of symptoms.
7. Surgery: it is more common in lumbar discectomy and spinal canal enlargement. Kardaun and others analyzed the causes of CES after lumbar intervertebral disc surgery, and thought that (1) rough operation or nerve stripper compressing dural sac and cauda equina tissue for too long directly damaged cauda equina nerve and nerve root; (2) Unreasonable laminectomy and decompression lead to instability or spondylolisthesis of lumbar spine; (3) Postoperative scar formation directly compresses the cauda equina.