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Rehabilitation Practice and Science

Translated Title

馬尾室管膜瘤

Abstract

Low back pain is a frequent complaint in PM&R OPD. Tumors of the cauda equina play an uncommon but nevertheless important role in the ”sciatic syndrome”. Early detection will lower the risk of neurological sequelae. However, on clinical grounds alone, it is sometimes difficult to differentiate between a cauda equina tumor and a prolapsed interver-tebral disc. Recent advances in imaging techniques had increased the diagnostic rates. This study was based on 6 cases of ependymoma of the cauda equina, collected from January 1986 to May 1992 at VGHTC. Three of them were detected at PM&R OPD. The clinical symptoms, physical examination, treatment and outcome will be discussed.The initial symptom is back or buttock pain (100%), while one case was combined with headache, vomiting and neck stiffness which proved to be subarachnoid hemorrhage later. The late symptoms include sensory deficit (100%), motor deficit (50%) and sphincter disturbance (67%). Nocturnal pain (67%), which is rare in herniated intervertebral discs, is a traditional feature of the cauda equina tumor. MRI or CT-myelogram are efficient diagnostic tools. After surgical excision with or without radiotherapy, most symptoms relieved. Two out of four cases with preexisting urination problems improved after surgery. Two cases developed difficulty in urination post-operatively. After bladder training, they regained their function within 4 weeks.

Language

English

First Page

169

Last Page

175

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