SPHINCTER INVOLVEMENT IN LUMBAR DISC HERNIATION

A retrospective analysis of 30 operated cases of prolapsed lumbar disc with cauda equina syndrome was carried out. 27 were male and 3 were female. Age varied from 27 to 60 years. 10 were acute presentation and 20 had previous history of backache-sciatica syndrome. The most common sphincter dysfunction was urinary retention and other neurological findings, pointing to sphincter involvement were impairment of sensation in the perineum, lax anal sphincter and absent superficial anal reflex. The other motor or sensory deficit depended on level of disc herniation. The majority of our patients reached us between 7-14 days after onset of sphincter dysfunction. Emergency myelogram was the most common investigation done and L 4/5 was most common disc herniation. Emergency surgery was done in 24 cases and semi emergency in 6 cases. Patients were followed up and at 1 year follow-up 12 had recovered fully, 7 partially and in rest 11 patients there was no significant improvement in sphincter functions.