Horsetail is a nerve fiber component. Now that the injury has occurred, it means that oppression or external force is not generally serious. Nerve fibers may also be irreversibly damaged, even partially or completely broken, so most patients will receive decompression surgery or nutritional nerve therapy, but they will also partially recover.
It is well known that surgery can restore some muscle strength and sensation within 48 hours after cauda equina nerve injury, which may be related to the nerve repair mechanism, because the knee joint is far from the injury. It can also be seen that the cauda equina nerve injury is closely related to the degree of injury. If it can be treated in time within 6 or 8 hours after injury, the secondary injury of nerve compression and edema can be prevented theoretically. However, there are few cases of cauda equina nerve injury that can be treated in time. This is also a reason why many patients recover slowly.
As mentioned earlier, the cauda equina nerve is a component of nerve fibers, so the cauda equina nerve fibers are located in the lumbar cistern, which is the terminal segment of the spinal cord. Its nerve bundles and root filaments float in cerebrospinal fluid, which is more active than cervicothoracic spinal cord and has greater cushioning and impact resistance in space mechanics (except tethered spinal cord, of course).
The simple understanding is that cauda equina nerve is not easy to be damaged under external force. But once it is damaged, it may indicate that the instantaneous violence and impact are very serious. It leads to instantaneous fracture bursting and crushing, and the arterioles supplying cauda equina twitch, ischemia and even rupture in severe shock. Another compression caused by fracture or disc herniation is the chronic process of ischemia and neurodegeneration. Before the completely irreversible change, it is possible to recover after deducting compression. In addition, one of the reasons for poor postoperative results may be that nerve root filaments or fascia are attached to scar tissue, resulting in tethered spinal cord!
The cauda equina nerve anatomically includes the lumbosacral 2-5 1-3 nerve roots, so the sciatic nerve is also included in the cauda equina nerve. Clinically, the symptoms of sciatic nerve can not be attributed to cauda equina injury, because the prognosis of the two is too different. Generally speaking, once the symptoms of cauda equina nerve injury reach the surgical standard, it needs to be operated in time. However, cauda equina nerve injury includes the symptoms of sciatic nerve, which leads to the expansion of surgery, many clinical difficulties and the possibility of secondary injury.
However, 90% patients can be treated conservatively if they only have symptoms of sciatic nerve. Even if there are symptoms of injury, there is a greater possibility of recovery. However, once there is sphincter disorder, incontinence or urinary retention, numbness in sellar region, male patients will have sexual dysfunction. The possibility of recovery is greatly reduced. This is not only the problem of sciatic nerve, but also the injury of cauda equina makes it more difficult to recover, so the recovery of cauda equina nerve injury is not very fast, but it can be recovered, but it will take longer than other nerve injuries, and the recovery is more incomplete than other traumatic diseases.
Cauda equina nerve injury is a difficult and complicated disease at home and abroad and even in the world. Clinical medicine is relatively common, and there is no good diagnosis and treatment method at present.
In clinical medicine, the etiology of the disease is mostly lumbar spinal stenosis and nerve compression caused by various reasons.
The main manifestations are perineal perception disorder, sphincter disorder and sexual dysfunction. Many of them are due to the fracture of the patient's cervical and lumbar region or the collateral damage caused by the doctor during the operation.
Since 1949 was named cauda equina syndrome for the first time in clinical statistics, the corresponding diagnosis and treatment methods have been selected in the past 60 years. Conventional traditional diagnosis and treatment include drug therapy for nourishing nerves, such as taking B vitamins and mecobalamin tablets. The mainstream diagnosis and treatment method is still surgery, and most of them use microsurgical equipment, such as lumbar decompression, anterior decompression or internal fixation, cauda equina anastomosis, cauda equina neurolysis and so on. The main purpose is to eliminate nerve compression and release adhesion.
However, considering the unreasonable choice of surgical treatment, it destroys the stability of the spine and leads to iatrogenic lumbar instability, lumbar spondylolisthesis and spinal stenosis, it is necessary to adopt reoperation. Because of the variability of surgical treatment, surgical treatment is unskilled and violent. It is easy to further promote the injury of cauda equina, making more and more patients unwilling to try several times. What makes the patient suffer is neurasthenia and depression, which deepens other symptoms of the disease.
A successful patient can relieve symptoms in a short time, but it can't control the development of the course. At the same time, there are various external environmental factors, and few people can really "eradicate". The early detection, control and development of diseases have always been a difficult problem for western medicine. Many people hope for the treatment of traditional Chinese medicine, and the assistance of traditional Chinese medicine decoction makes the disease possible.
According to relevant data, the number of patients with cauda equina nerve injury caused by lumbar fracture, spinal anesthesia, improper operation and other factors is increasing year by year, which will not only seriously endanger the physical and mental health of patients, but also increase the huge burden on their families and society.
Traditional Chinese medicine (TCM) treats cauda equina injury mainly by reinforcing method.
Tonifying traditional Chinese medicine is one of the most commonly used treatment methods. It is a method to treat various deficiency syndromes by nourishing the deficiency of qi, blood and yin and yang, which is not only a tonic method. Tonifying method can improve the function of zang-fu organs, enhance physical fitness, improve disease resistance and eliminate weak symptoms of the body. Through a long-term summary, the comprehensive treatment of orthopedics and nerve injury by tonic method of traditional Chinese medicine has achieved good clinical results.
Shengjingyiqi decoction explains that there is no "nerve injury" in traditional Chinese medicine, and mainly divides cauda equina nerve injury into three concepts for symptomatic treatment.
1. Concept of Meridian: Meridian described by Lingshu Meridian is a continuous tissue from the extremities to the head or trunk, which is regularly distributed in the trunk of human body like meridian, with starting and ending, circulation, trunk, branches, collaterals and specific diseases. To sum up, meridians exist independently, running through all parts of the human body, much like nerves.
2. Concept of arthralgia syndrome: "arthralgia syndrome" means obstruction. Arthralgia syndrome is a disease caused by pathogenic factors blocking meridians and affecting qi and blood circulation, resulting in pain, heavy attachment, sadness, numbness, or unfavorable joint flexion and extension. Su Wen Bi Lun not only puts forward the disease name of Bi syndrome, but also discusses its etiology, pathogenesis, syndrome classification and prognosis in detail.
3. Concept of flaccidity syndrome: The meaning of "flaccidity" in traditional Chinese medicine includes withering, atrophy, muscle weakness, dyskinesia and so on. Flaccidity syndrome refers to a kind of disease in which limbs are flaccid and weak, unable to exercise autonomously, or accompanied by muscle atrophy. Lower limb weakness is more common in clinic, also known as "flaccidity?" . Traditional Chinese medicine has a long history of understanding flaccidity syndrome. According to Su Wen's theory of flaccidity, there are three kinds of flaccidity in ancient Treatise on Febrile Diseases and Xia Jing: pulse flaccidity, muscle flaccidity and bone flaccidity. At that time, the name of impotence was derived from the five internal organs.
In the process of Chinese medicine treatment, it is also based on invigorating qi and nourishing blood, dredging collaterals, tonifying deficiency and strengthening the body resistance, nourishing liver and kidney, so that limbs, skin and meat can be warmed by normal qi and blood, thus making the symptoms of limb weakness and skin numbness disappear. Because ponytail belongs to the category of meridians and tendons, the liver is the main tendon and the liver blood is sufficient, then the tendon is nourished, the liver and kidney are homologous, the tendon is attached to the bone, and kidney deficiency is often the internal cause of tendon injury diseases. Traditional Chinese medicine comprehensively considers the physical condition of patients with cauda equina nerve injury and makes comprehensive diagnosis and treatment.