신경근을 압박하는 척추 질환의 요역동학적 분석
The Urodynamic Study in Vertebral Disorders with Nerve Root Compression
송인호, 신현덕, 진성희,
소속 상세정보
송인호 ( )
단국대학교 의과대학 비뇨기과학교실
신현덕 ( )
단국대학교 의과대학 비뇨기과학교실
진성희 ( )
단국대학교 의과대학 정형외과학교실
KMID : 0358319990400070841
Abstract
결론
척수의 신경근을 압박하는 질환에서 배뇨기능에 대한 평가와 요역동학검사를 한 결과 총
33명의 환자 중 배뇨장애의 증상이 있는 환자는 20례(60.6%)였으며 요역동학검사에서 이상
소견을 보인 환자는 24례(72.7%)였다. 또한 배뇨장애의 증상과 요역동학검사 소견이 다양하
였다. 따라서 척추협착증환자나 추간판탈출증과 같이 척수의 신경근을 압박하는 질환을 수
술하려고 할 때 반드시 비뇨기과 의사의 자문과 요역동학검사가 필요할 것으로 보여진다.
또한 술전 요역동학검사는 환자들에게 술전 상태를 설명할 수 있는 근거를 마련해 주어 술
후 발생 가능성이 있는 법의학적 의료 소송을 줄이고 수술자에게 부담을 덜게 해 주는 중요
한 검사라고 생각된다.
Purpose: Nerve root compression from spinal stenosis or herniated intervertebral
disc(HIVD) may affect bladder function by the disease itself, operation or inappropriate
general postoperative care. Preoperative urodynamic study seems to be needed for
differential diagnosis of postoperative bladder dysfunction.
Materials and Methods: Thirty three patients diagnosed as nerve root compression
were analysed for urodynamic features prospectively and classified into type Ⅰ
(hyporeflexic, hyposensitive, normal sphincter and hypocontractile, high compliance), type
Ⅱ(hyperreflexic, hypersensitive, normal sphincter and hypocontractile, low compliance),
type Ⅲ(hyperreflexic, hypersensitive, normal sphincter and hypercontractile, low
compliance) and normal. Correlation with voiding symptoms, duration of the disease and
urodynamic findings was evaluated.
Results: The moan age of patients was 56.2 years(29-80 years old), including 21 men
and 12 women. Among thirty three patients, 21 had spinal stenosis and twelve patients
were diagnosed as HIVD. Urodynamically, there were 16 cases(48.5%) showing type Ⅱ,
6 cases(18.2%) for type Ⅰ and 2 cases(6%) for type Ⅲ. Normal finding was shown in 9
cases(27.3%). No significant difference was shown in mean duration of disease and in
urodynamic findings. Patients with voiding symptoms or abnormal urodynamic finding
were 20 cases(60.6%) and 24 cases(72.7%), respectively. Among thirteen patients without
voiding symptoms, eight patients(61.5%) had abnormal urodynamic findings.
Conclusions: Voiding symptoms and urodynamic findings in patients with nerve root
compression were various. Because there is no consistent pattern of dysfunction with
any type of nerve root compression disease, preoperative urodynamic study seems to
the cornerstone for rational therapy and gives the exact information of bladder function
to orthopedic operator.
키워드
Nerve root compression; Herniated intervertebral disc; Spinal stenosis; Urodynamic study;
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