마미 신경의 해부학적 및 병태생리학적 특징

김도연,이광복 대한척추외과학회 2013 대한척추외과학회지 Vol.20 No.4

Study Design: Review of literature on anatomical and pathophysiological features of cauda equina. Objectives: To look into the anatomical and pathophysiological features of cauda equina and support their basic knowledge of treating cauda equina syndrome. Summary of Literature Review: Cauda equina has different anatomical and pathophysiological features to peripheral nerve. Materials and Methods: Review of literature. Results: When compressing to cauda equina, the pathophysiologic mechanism develop as follows; increasing the vascular permiablity of nerve root, intraneural edema, and subsequent blood and nutritional impairment. Nerve root injury develops through this pathophysiologic mechanism. Conclusions: Cauda equina has an extensive ateriovenous anastomosis and guaze-like pia mater, which supply blood and neutrition to it. These anatomical features prevent it from complete cauda equina syndrome when compressing to it under arterial blood pressure. 연구 계획: 마미 신경의 해부학적 병태생리학적 특징에 대한 문헌 고찰. 목적: 마미 신경의 해부학적 병태생리학적 특징을 알아보고 마미 증후군을 치료하는데 있어서 기초적인 지식을 제공하고자 한다. 선행문헌의 요약: 마미 신경은 말초 신경과 다른 해부학적 병태생리학적 특징을 가지고 있다. 대상 및 방법: 문헌 고찰결과: 마미 신경이 압박 될 때 병태생리학적 기전은 신경의 혈관 투과성 증가, 신경내 부종, 혈액 및 영양 공급 장애가 나타난다. 신경근 손상은 이러한병태생리학적 기전을 통해 일어난다. 결론: 마미 신경은 많은 동정맥 문합과 망상구조의 수막으로 되어 있어 혈액 및 영양 공급이 잘 이루어 진다. 이러한 해부학적 특징으로 인해 압박력이동맥혈압 이하로 적용된다면 완전한 마미 증후군이 발생하지 않게 된다.

Bisected Vertebral Body Fracture Trapping Cauda Equina - A Case Report -

남경혁,이수현,한인호,이재일,최병관 대한척추신경외과학회 2010 Neurospine Vol.7 No.2

In most thoracolumbar burst fractures, the spinal cord or cauda equina is compressed and displaced posteriorly by the retropulsed bone fragments in the spinal canal. We report a rare case of an L3 burst fracture in which the cauda equina was trapped in the crack of a bisected vertebral body with anterior displacement. To decompress the neural elements, we attempted a total laminectomy and facetecomy with manipulation of the retropulsed bone fragment and indirect instrumental reduction, but failed to relieve the cauda equina. Finally, we were able to relieve the cauda equina via a discectomy and bilateral removal of the bony portion that was entrapping the cauda equina. One month after the first surgical procedure, an anterior corpectomy of L3 and interbody fusion with a mesh cage and allograft to support the anterior column were performed.

A Case of Cauda Equina Syndrome in Early-Onset Chronic Inflammatory Demyelinating Polyneuropathy Clinically Similar to Charcot-Marie-Tooth Disease Type 1

Lee, Seung Eun,Park, Seung Won,Ha, Sam Yeol,Nam, Taek Kyun The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.55 No.6

To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

척수 마미부에 생긴 2예의 해면상 혈관종 : 증례 보고 Case Report

안창호,지철,조경근,이경진,이길송,윤석훈,최창락 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.6

Two cases of cavernous hemangioma of the cauda equina are presented. Cavernous hemangioma of the cauda equina is rare vascular malformation. This is the fifth and sixth case of cavernous hemangioma of the cauda equina in the literature. These cases are female patients. MRI is more sensitive method than spinal myelography and CT in diagnosis of cavernous hemangioma of the cauda equina. Total removal was possible without immediate post-operative complication.

마미총에서 발생한 부신경절종

황용순,문재곤,장희경,조영덕,김한규,이화동 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.11

Paraganglioma of the cauda equina or filum terminate is rare tumor and was first described in 1970. The authors present a case of paraganglioma of the cauda equina in a 55 year-old-man with nonspecific back pain. To our knowledge, there has been only a few report of MRI of a paraganglioma of the cauda equina. Diagnosis can be made with immunohistochemical study and electron microscopy after surgical removal. Because of frequent recurrence, total excision is mandatory.

Hypertrophic Interstitial Neuritis of Cauda Equina : Case Report with Myelographic Findings 脊髓造影術 所見

Chee, Sun Ho 梨花女子大學校 醫科大學 醫科學硏究所 1979 EMJ (Ewha medical journal) Vol.2 No.2

De´jerine-Sottas 症侯群이라 불리우는 肥大性 間質神經炎은 Schwann 神經?의 增生(hyper plasia)으로 因한 末梢神經의 肥厚(thickening)를 招來하는 疾患이다. 著者는 41歲 男子의 馬尾叢(cauda equina)에 發生된 肥大性 間質神經炎 1例를 經驗한바 이를 手術에 依하여 確認하였고 그 特徵的인 脊髓造影術所見의 發現機轉을 論議하였다. The author reports a case of surgery-proved hypertrophic interstitial neuritis of cauda equina. The pathogenesis of the unique myelographic findings is described and illustrated. SUMMARY A case of surgery-proved hypertrophic interstitial neuritis of cauda equina is reported. The unique myelographic findings are illustrated. To the author's knowledge, no other condition produces these abnormalities.

Cauda Equina Syndrome Caused by Idiopathic Epidural Lipomatosis

김윤성,주창일,김석원,Hyeun Sung Kim 대한척추신경외과학회 2015 Neurospine Vol.12 No.4

Spinal epidural lipomatosis (SEL) is a rare condition that presents as a back pain with progressive neurologic symptoms. Most affected patients are obese and receiving steroid therapy, or have an endocrinopathies. We report a rare case of cauda equina syndrome caused by SEL in a non-obese healthy young man without any evident traumatic episode. A healthy 19-year-old man, who had experienced lower back pain for two months, visited our emergency room because of the sudden development of motor weakness and voiding difficulty. Lumbar magnetic resonance image revealed extradural fat compressing the cauda equina. Urgent decompression via posterior laminectomy and excision of excess epidural fat resulted in an immediate symptom improvement.

마미에서 발생한 부신경절종

강석진,이연수,김병기,심상인 대한병리학회 1997 Journal of Pathology and Translational Medicine Vol.31 No.9

마미 부위에서 발생한 모세혈관종: 증례 보고

박지영,이상호,조병준,박현선 대한영상의학회 2005 대한영상의학회지 Vol.53 No.1

Capillary hemangioma of the cauda equina is extremely rare. We present the MR imaging and histologic findings of a case of this disease. The tumor was well demarcated, 0.9×1.3 cm in diameter and 1.2 cm in length. On the MR images, the tumor showed isointensity relative to the spinal cord on the T1-weighted images, hyperintensity on the T2-weighted images, and strong homogeneous enhancement on the contrast-enhanced T1-weighted images. Capillary hemangioma should be included in the differential diagnosis of a spinal tumor of the cauda equina. 마미 부위 모세혈관종은 세계적으로 아주 드물게 발생한다. 저자들은 경계가 깨끗한 마미부위 경막내 종양으로 발견된 모세혈관종 1예를 경험하였으며 드물기는 하나 마미 부위 종양의 감별 진단 시 모세혈관종도 포함되어야 할 것으로 생각된다.

Clear Cell Meningioma of Cauda Equina without Dural Attachment : :A case Report

Cho, Chul Beom,Kim, Jae-Keon,Cho, Kyoung-Suck,Kim, Dal-Soo 최신의학사 2003 最新醫學 Vol.46 No.9-10