背景除了活动性脊柱神经鞘瘤罕见外，这些肿瘤与椎间盘突出共存的情况也很少见。此外，作为椎管内神经鞘瘤的一种表现形式的马尾综合征（CES）也鲜有报道。这里描述的是一例同时存在腰椎间盘突出和活动性脊柱神经鞘瘤，并伴有间歇性 CES 症状的病例。病例报告 一名 62 岁男性，出现持续两周的严重间歇性腿部疼痛，随后进展为下肢无力和排尿困难。磁共振成像显示，在相隔 6 小时的扫描中，椎管内肿瘤相对于 L1-2 椎间盘突出移动了位置，并伴有相关症状的自发消退。该肿瘤被发现是一种移动性脊髓神经鞘瘤，起源于神经根。采用标准显微切割技术，通过保留棘突的单侧入路切除肿瘤，并对 L1 进行完全椎板切除。术中超声的使用有助于肿瘤的准确定位。术后，患者不再出现症状。结论 本报告结合了一种常见的脊柱病理学——椎间盘突出症，以及一种罕见的疾病——活动性脊柱神经鞘瘤，其不常见的临床表现，如 CES，可导致不可逆的神经功能缺损。外科医生在治疗患者时需要对潜在的非典型情况保持警惕。应使用术中成像来解决有关肿瘤移动性的手术治疗挑战，例如准确定位，以避免错误的手术水平。为了减轻不可逆的神经系统并发症，患者应该获得有关 CES 警报征兆的全面信息。

BACKGROUND Aside from the rarity of mobile spinal schwannomas, the coexistence of these tumors with herniated intervertebral disc is also scarce. Furthermore, cauda equina syndrome (CES), as a manifestation of intraspinal schwannomas has been reported rarely. Described here is a case of simultaneous lumbar disc bulge and mobile spinal schwannoma presented with intermittent symptoms of CES. CASE REPORT A 62-year-old man presented with severe but intermittent leg pain for 2 weeks, which later progressed to an episode of lower extremity weakness and difficulty in urination. Magnetic resonance imaging revealed an intraspinal tumor that moved in position relative to the L1-2 disc bulge on scans 6 h apart, with associated spontaneous regression in symptoms. The tumor was found to be a mobile spinal schwannoma, originated from a nerve root. A standard microdissection technique was used to remove the tumor through a spinous process-sparing unilateral approach, with complete laminectomy of L1. Use of intraoperative ultrasound facilitated the accurate tumor localization. Postoperatively, the patient no longer had symptoms. CONCLUSIONS This report presents a combination of a common spinal pathology, intervertebral disc herniation, alongside a rare condition, mobile spinal schwannoma, whose uncommon clinical manifestations, such as CES can cause irreversible neurological deficits. Surgeons need to remain vigilant of potential atypical scenarios when treating patients. Surgical treatment challenges regarding the mobility of tumors, such as accurate localization, should be addressed using intraoperative imaging to avoid wrong-level surgery. To mitigate the irreversible neurological complications, patients should receive comprehensive information for alarming signs of CES.