scholarly journals Development of a toolkit for early identification of cauda equina syndrome

2016 ◽  
Vol 17 (06) ◽  
pp. 559-567 ◽  
Author(s):  
Sue Greenhalgh ◽  
Carole Truman ◽  
Valerie Webster ◽  
James Selfe
Keyword(s):  
At Risk ◽  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Lower Limbs ◽  
Motor Deficit ◽  
Medical Setting ◽  
Low Back ◽  
Content Validation

AimTo develop a simple cauda equina syndrome (CES) toolkit to facilitate the subjective examination of low back pain patients potentially at risk of CES. To undertake preliminary validation of the content of the toolkit.BackgroundCES is a rare condition which can be very challenging to identify in a generalist medical setting.MethodA three phase iterative design with two stake holder groups; extended scope practitioners experienced in managing CES patients and CES sufferers.Toolkit developmentSynthesis of existing CES literature with CES patient data generated from in depth interviews.Toolkit validationContent validation of the draft toolkit with CES patients.Toolkit validationContent validation of the draft toolkit with extended scope physiotherapists.FindingsA three arm toolkit has been developed for use with patients considered by the clinician as at risk of developing CES (eg, worsening low back pain with symptoms/signs of progressive sensory-motor deficit in the lower limbs); patient expertise, clinical expertise, research and pathways. Uniquely, the toolkit drew upon the lived experiences of patients suffering from CES to inform the content.

Low Back Pain in a Child Associated With Acute Onset Cauda Equina Syndrome

2012 ◽  
Vol 32 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Juan Pretell-Mazzini ◽  
Kudakwashe R. Chikwava ◽  
John Paul Dormans
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Acute Onset ◽  
Low Back

scholarly journals The many faces of primary cauda equina myxopapillary ependymoma: clinicoradiological manifestations of two cases and review of the literature

2017 ◽  
Vol 31 (3) ◽  
pp. 385-390
Author(s):  
Mohammad Zare Mehrjardi ◽  
Samira Mirzaei ◽  
Hamid Reza Haghighatkhah
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Imaging Modality ◽  
Cauda Equina ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Conus Medullaris ◽  
Lower Limbs ◽  
Myxopapillary Ependymoma ◽  
Low Back

Abstract Introduction: Myxopapillary ependymoma (MPE) is a benign and slow growing tumor that originates exclusively from the conus medullaris and cauda equina nervous tissue. It occurs more commonly in young patients. In addition, clinical presentations are non-specific and may mimic benign conditions. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating this tumor. We hereby report on two young patients with long-lasting non-specific symptoms, which were clinically attributed to benign conditions. However, cauda equina tumor was revealed on MRI in both patients. Case report: Two cases of cauda equina MPE, a 19-year-old female and a 38-year-old male, with different clinical manifestations are reported. The first patient presented with paresis and paresthesia of the lower limbs, and the second patient’s complaint was chronic low-back pain and urinary incontinence. In both cases, MRI detected a tumor originated from the cauda equina, and histopathologic examination was compatible with MPE. Conclusion: Cauda equina tumors should be considered as a differential diagnosis in the young patients presented with neurologic deficits in the lower limbs, sphincter or erectile dysfunction, and even a simple low-back pain (particularly when symptoms are long-lasting and/or progressive).

scholarly journals What is the incidence of cauda equina syndrome? A systematic review

2020 ◽  
Vol 32 (6) ◽  
pp. 832-841 ◽  
Author(s):  
Ingrid Hoeritzauer ◽  
Matthew Wood ◽  
Phillip C. Copley ◽  
Andreas K. Demetriades ◽  
Julie Woodfield
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Adult Population ◽  
Cauda Equina ◽  
Small Sample ◽  
Low Back ◽  
Patient Pathways

OBJECTIVECauda equina syndrome (CES) is a surgical emergency requiring timely operative intervention to prevent symptom progression. Accurately establishing the incidence of CES is required to inform healthcare service design and delivery, including out-of-hours imaging arrangements.METHODSA systematic literature search of MEDLINE, EMBASE, and Scopus was undertaken to identify original studies stating the incidence of CES, and the estimates were combined in a meta-analysis as described in the protocol registered with PROSPERO (registration no. CRD42017065865) and reported using the PRISMA guidelines.RESULTSA total of 1281 studies were identified, and 26 studies were included in the review. Data about CES incidence were available from 3 different populations: asymptomatic community populations, patients with nontraumatic low-back pain, and patients presenting as an emergency with suspected CES. The incidence of CES was 0.3–0.5 per 100,000 per year in 2 asymptomatic community populations, 0.6 per 100,000 per year in an asymptomatic adult population, and 7 per 100,000 per year in an asymptomatic working-age population. CES occurred in 0.08% of those with low-back pain presenting to primary care in 1 study, and a combined estimate of 0.27% was calculated for 4 studies of those with low-back pain presenting to secondary care. Across 18 studies of adults with suspected CES, 19% had radiological and clinical CES. Difficulties in comparison between studies resulted from the heterogeneous definitions of CES and lack of separation of more advanced CES with retention, which is unlikely to be reversible. In the studies of patients with suspected CES, the small sample size, the high number of single-center studies (18/18), the high number of studies from the United Kingdom (17/18), the retrospective nature of the studies, and the high number of abstracts rather than full texts (9/18) reduced the quality of the data.CONCLUSIONSFrom current studies, it appears that CES occurs infrequently in asymptomatic community populations and in only 19% of those presenting with symptoms. Determining accurate incidence figures and designing a bespoke service for investigation of patients with suspected CES would require a consensus clinical and radiological definition of CES and international multisite studies of patient pathways of investigation and management.

scholarly journals Posterior epidural migration of a lumbar disc herniation

2020 ◽  
Vol 11 ◽  
pp. 4
Author(s):  
Meryem Himmiche ◽  
Khalid Chakour ◽  
Mohammed El Faiz Chaoui ◽  
Mohammed Benzagmout
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Low Back ◽  
Case Description ◽  
Disc Material ◽  
Disc Herniations ◽  
History Of

Background: Posterior epidural migration of a lumbar disc fragment (PEMLDF) refers to the dorsal migration of disc material around the thecal sac that can lead to radiculopathy and/or cause a cauda equina syndrome. It is rare and the diagnosis is often just established intraoperatively. Case Description: A 50-year-old male with a chronic history of low back pain and psychosis presented with PEMLDF originating at the L4–L5 level. Conclusion: Lumbar disc herniations rarely present as PEMLDF resulting in symptoms varying from radiculopathy to cauda equina syndrome. These should be included among the differential diagnostic considerations for dorsolateral epidural lesions.

BET 2: Is sexual dysfunction a recognised sign of cauda equina syndrome in the ED?

2019 ◽  
Vol 36 (8) ◽  
pp. 508-510
Author(s):  
Michelle Angus ◽  
Daniel Horner
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sexual Dysfunction ◽  
Cauda Equina Syndrome ◽  
Search Strategy ◽  
Cauda Equina ◽  
Low Back ◽  
Red Flag ◽  
Study Type ◽  
New Onset

A shortcut review of the literature was carried out to examine the association of sexual dysfunction in the context of new-onset low back pain, with cauda equina syndrome (CES). Five papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that clinicians appear to be poor at recording this feature during assessment, but between 12% and 96%, patients with confirmed CES will report the presence of new-onset sexual dysfunction at presentation when asked. It appears that this can also be a single isolated red flag feature in the context of low back pain and as such should be a mandatory part of any clinical assessment that seeks to evaluate the risk of impending CES.

scholarly journals Atypical variant of Baastrup’s disease with lumbar stenosis and cauda equina syndrome

2019 ◽  
Vol 10 ◽  
pp. 198
Author(s):  
Kartikeya Shukla ◽  
Jaskaran Singh Gosal ◽  
Mayank Garg ◽  
Suryanarayanan Bhaskar ◽  
Deepak Kumar Jha ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Neurological Deficits ◽  
Low Back ◽  
Canal Stenosis ◽  
Baastrup’S Disease ◽  
Degenerative Disorder ◽  
Lumbar Spinal

Background: Classical Baastrup’s disease is a degenerative disorder of the lumbar spine characterized by the approximation of adjacent spinous processes due to excessive lordosis. This results in edema, sclerosis, cyst, bursitis, and midline epidural fibrosis and is often overlooked as a cause of low back pain. Here, we report a patient with atypical Baastrup’s disease and lumbar spinal stenosis who presented with a cauda equina syndrome. Case Description: A 67-year-old male presented with low back pain of 1 year’s duration. This exacerbated over the past 3 weeks, becoming associated with the left lower limb numbness/weakness and bladder dysfunction. The lumbar magnetic resonance (MR) showed atypical Baastrup’s disease characterized by multiple ill-defined areas of contrast enhancement in the paraspinal region in conjunction with lumbar canal stenosis. The patient underwent lumbar decompression and exhibited improvement in his neurological deficits postoperatively. Conclusion: This case highlights the atypical MR features of lumbar Baastrup’s disease in conjunction with stenosis. Atypical Baastrup’s disease should be differentiated from classical Baastrup’s disease or other infectious pathologies (e.g., Pott’s disease of the spine) and appropriately treated with timely spinal decompression.

Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

2019 ◽  
pp. 3-13
Author(s):  
Alexandru Cîtea ◽  
George-Sebastian Iacob
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Human Body ◽  
Sagittal Plane ◽  
The Body ◽  
Lower Limbs ◽  
Low Back ◽  
Pilates Method ◽  
The Relationship

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

scholarly journals Guillain-Barré syndrome and Low back pain: two cases and literature review

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 503-508
Author(s):  
Xianjun Ding ◽  
Hong Jiang ◽  
Xingyue Hu ◽  
Hong Ren ◽  
Huaying Cai
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina ◽  
Guillain Barre Syndrome ◽  
Low Back ◽  
Mri Features ◽  
Prominent Symptom ◽  
Guillain Barré Syndrome ◽  
Lumbar Mri ◽  
Guillain Barré

AbstractPurpose. To describe the clinical, electrophysiological, and lumbar magnetic resonance imaging (MRI) features of two cases of atypical Guillain-Barré syndrome (GBS). Methods We reported two GBS variant cases with initial and prominent symptoms of low back pain. We analysed their clinical, electrophysiological, and lumbar MRI features. Results Two patients with GBS reported low back pain as the initial and prominent symptom, which was not accompanied by limb weakness. The electrophysiological study showed abnormal F-waves in the common peroneal and tibial nerves, and acute polyradiculoneuropathy in the cauda equina. Examination of the cerebrospinal fluid (CSF) showed albuminocytologic dissociation. Serum was positive for GQ1b-IgM antibodies. Lumbar MRI showed gadolinium enhancement of the nerve roots and cauda equina. A standard regime of intravenous immunoglobulin markedly alleviated the low back pain. Conclusions Low back pain caused by GBS should be differentiated from other diseases. This initial or early prominent symptom may delay the diagnosis of GBS; therefore, it is important to conduct a detailed electrophysiological, CSF, and gadolinium-enhanced lumbar MRI analysis.

scholarly journals SAT0588 Healthcare workers are not more at risk to low back pain than other occupations

2017 ◽  
Author(s):  
F Kemta Lekpa ◽  
MS Doualla ◽  
HB Ngahane Mbatchou ◽  
AS Mkoh ◽  
H Namme Luma
Keyword(s):  
At Risk ◽  
Low Back Pain ◽  
Back Pain ◽  
Healthcare Workers ◽  
Low Back
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