scholarly journals Does a history of lumbar spine surgery predict radiological cauda equina compression in patients undergoing MRI for suspected cauda equina syndrome?

2019 ◽  
Vol 34 (1) ◽  
pp. 76-79
Author(s):  
Savva Pronin ◽  
Julie Woodfield ◽  
Ingrid Hoeritzauer ◽  
Alan Carson ◽  
Jon Stone ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Lumbar Spine Surgery ◽  
Cauda Equina Compression ◽  
History Of

scholarly journals Progressive growth of arachnoid cysts with cauda equina syndrome after lumbar spine surgery

2013 ◽  
Vol 76 (9) ◽  
pp. 527-531 ◽  
Author(s):  
Raphaël Hung-Kai Weng ◽  
Ming-Chau Chang ◽  
Shang-Wen Feng ◽  
Shih-Tien Wang ◽  
Chien-Lin Liu ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Arachnoid Cysts ◽  
Lumbar Spine Surgery ◽  
Progressive Growth

Cauda Equina Syndrome Following Lumbar Spine Surgery: 6 Cases Report

1997 ◽  
Vol 32 (7) ◽  
pp. 1773 ◽  
Author(s):  
Hyeung Seok Kim ◽  
Ki Do Hong ◽  
Sung Sik Ha ◽  
Sun Woo Lee
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Lumbar Spine Surgery

scholarly journals An analysis from the Quality Outcomes Database, Part 1. Disability, quality of life, and pain outcomes following lumbar spine surgery: predicting likely individual patient outcomes for shared decision-making

2017 ◽  
Vol 27 (4) ◽  
pp. 357-369 ◽  
Author(s):  
Matthew J. McGirt ◽  
Mohamad Bydon ◽  
Kristin R. Archer ◽  
Clinton J. Devin ◽  
Silky Chotai ◽  
...  
Keyword(s):  
Decision Making ◽  
Lumbar Spine ◽  
Predictive Model ◽  
Spine Surgery ◽  
Smoking Status ◽  
Lumbar Spine Surgery ◽  
Symptom Duration ◽  
Quality Outcomes ◽  
Pain Outcomes ◽  
History Of

OBJECTIVEQuality and outcomes registry platforms lie at the center of many emerging evidence-driven reform models. Specifically, clinical registry data are progressively informing health care decision-making. In this analysis, the authors used data from a national prospective outcomes registry (the Quality Outcomes Database) to develop a predictive model for 12-month postoperative pain, disability, and quality of life (QOL) in patients undergoing elective lumbar spine surgery.METHODSIncluded in this analysis were 7618 patients who had completed 12 months of follow-up. The authors prospectively assessed baseline and 12-month patient-reported outcomes (PROs) via telephone interviews. The PROs assessed were those ascertained using the Oswestry Disability Index (ODI), EQ-5D, and numeric rating scale (NRS) for back pain (BP) and leg pain (LP). Variables analyzed for the predictive model included age, gender, body mass index, race, education level, history of prior surgery, smoking status, comorbid conditions, American Society of Anesthesiologists (ASA) score, symptom duration, indication for surgery, number of levels surgically treated, history of fusion surgery, surgical approach, receipt of workers’ compensation, liability insurance, insurance status, and ambulatory ability. To create a predictive model, each 12-month PRO was treated as an ordinal dependent variable and a separate proportional-odds ordinal logistic regression model was fitted for each PRO.RESULTSThere was a significant improvement in all PROs (p < 0.0001) at 12 months following lumbar spine surgery. The most important predictors of overall disability, QOL, and pain outcomes following lumbar spine surgery were employment status, baseline NRS-BP scores, psychological distress, baseline ODI scores, level of education, workers’ compensation status, symptom duration, race, baseline NRS-LP scores, ASA score, age, predominant symptom, smoking status, and insurance status. The prediction discrimination of the 4 separate novel predictive models was good, with a c-index of 0.69 for ODI, 0.69 for EQ-5D, 0.67 for NRS-BP, and 0.64 for NRS-LP (i.e., good concordance between predicted outcomes and observed outcomes).CONCLUSIONSThis study found that preoperative patient-specific factors derived from a prospective national outcomes registry significantly influence PRO measures of treatment effectiveness at 12 months after lumbar surgery. Novel predictive models constructed with these data hold the potential to improve surgical effectiveness and the overall value of spine surgery by optimizing patient selection and identifying important modifiable factors before a surgery even takes place. Furthermore, these models can advance patient-focused care when used as shared decision-making tools during preoperative patient counseling.

A Polyostotic Paget’s Disease Involving Lumbar Spine Presenting with Cauda Equina Syndrome: An Unusual Entity

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Shailesh Hadgaonkar ◽  
Shaunak Patwardhan ◽  
Pramod Bhilare ◽  
Parag Sancheti ◽  
Ashok Shyam
Keyword(s):  
Lumbar Spine ◽  
Neurological Deficit ◽  
Cauda Equina Syndrome ◽  
Indian Subcontinent ◽  
Paget’S Disease ◽  
Cauda Equina ◽  
Neurological Complications ◽  
Paget's Disease ◽  
Metabolic Bone ◽  
Cauda Equina Compression

Introduction:Paget’s disease of bone (PDB) is a metabolic bone disease presenting as polyostotic or monostotic lesions of the spine. Although common in the Anglo-Saxon population, it is rare on the Indian subcontinent. Neurological complications though infrequent can be severe in pagetic spine. Case Report:We report a case of a polyostotic variant of PDB involving lumbar spine (L2 vertebrae), iliac bones, and femur presenting as chronic low back pain and neurological deficit, i.e., cauda equina syndrome. On initial workup, a diagnosis of PDB was made and given cauda equina compression with neurological deficit, posterior spinal decompression, and biopsy was performed. The histopathological evaluation confirmed the diagnosis and the patient was treated with bisphosphonates for 6 months, along with serial monitoring of alkaline phosphatase levels. Conclusion:Through this case report, we hope to emphasize that PDB should be considered as a possible cause of neurological symptoms at presentation, especially in elderly patients. Also furthermore, early surgical intervention followed by bisphosphonates therapy can lead to favorable outcomes in such patients. Keywords:Polyostotic, Paget’s disease, cauda equine syndrome, lumbar spine.

scholarly journals Cauda equina syndrome as a postoperative complication of lumbar spine surgery

2004 ◽  
Vol 16 (6) ◽  
pp. 34-38 ◽  
Author(s):  
Randy L. Jensen
Keyword(s):  
Lumbar Spine ◽  
Postoperative Complication ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Medical Emergency ◽  
Lumbar Spine Surgery ◽  
Imaging Studies ◽  
Decompressive Laminectomy ◽  
Postoperative Imaging ◽  
Compressive Neuropathy

Object The term “cauda equina syndrome” (CES) has been used to describe the signs and symptoms in patients with compressive neuropathy of multiple lumbar and sacral roots. This syndrome is well known as an indication for surgical intervention in treating lumbar spine disease, but relatively unknown as a postoperative complication following surgery for disease. In this study the author describes two cases of CES that occurred following uneventful lumbar spine procedures—one microdiscectomy and one decompressive laminectomy. Methods Preoperative, operative, and postoperative management is discussed and the relevant literature reviewed. One patient suffered perineal numbness and bowel and bladder difficulty following a decompressive laminectomy. Postoperative imaging studies were negative for residual lesion and the treatment goal pursued was partial long-term resolution of symptoms. The second patient had progressive numbness and weakness in the lower extremities. Results of urgent postoperative magnetic resonance imaging studies were inconclusive and repeated exploration was performed within hours of the initial procedure. The patient made a full recovery, although the intraoperative findings did not reveal a clear cause of the patient's symptoms. Conclusions Postoperative symptoms of partial or complete CES represent a medical emergency, especially if they are progressive. It is necessary to perform urgent postoperative imaging in patients, but the results are not always helpful. Surgical exploration is warranted if a mass lesion is demonstrated on imaging studies or if symptoms progress and the disease origin is not clear based on available information.

scholarly journals A History of Endoscopic Lumbar Spine Surgery: What Have We Learnt?

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
H. Michael Mayer
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Spine Surgery ◽  
Surgical Techniques ◽  
Lumbar Spine Surgery ◽  
Decompression Surgery ◽  
Surgical Technology ◽  
General Acceptance ◽  
Lumbar Decompression ◽  
History Of

The new development and finally the general acceptance of surgical techniques among the worldwide surgical community sometimes create fascinating stories. This is also true for the history of endoscopic lumbar spine surgery. In the last 100 years there was a “natural” evolution of surgical techniques with continuous improvement and “refinement” of lumbar decompression techniques towards less invasive operations with the final “endpoint” of microsurgery. However the application of percutaneous, image-guided, and endoscopic technologies has revolutionized minimally invasive surgery. This article describes the history of endoscopic lumbar spine surgery and its major milestones and protagonists which have helped to make endoscopic lumbar spine surgery “disruptive” minimally invasive surgical technology which has changed the world of lumbar decompression surgery.

scholarly journals Spinal subdural hygroma as a post-operative complication in revision spine fusion: a case report

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Michelle J Nentwig ◽  
Camden M Whitaker ◽  
Shang-You Yang
Keyword(s):  
Lumbar Spine ◽  
Cauda Equina Syndrome ◽  
Rare Complication ◽  
Fluid Collection ◽  
Cauda Equina ◽  
Spine Fusion ◽  
Lumbar Spine Surgery ◽  
Subdural Hygroma ◽  
Lumbar Spine Fusion ◽  
First Case

Abstract Lumbar spine fusion has become a common and effective procedure in orthopedic practice, and a spinal subdural hygroma development is a rare complication following this procedure. We report here the case of a revision lumbar spine fusion at levels L4-5, L5-S1, where the patient subsequently developed cauda equina syndrome 2 days post-operatively. Magnetic resonance imaging (MRI) showed a subdural, extra-arachnoid fluid collection from T12-L2, cephalad to the site of spine fusion. It appears the first case reported a subdural hygroma developed cephalad to the site of spine fusion. When a patient complains of radicular pain along with urinary retention and neurologic deficits post-lumbar spine surgery, cauda equina syndrome possibly caused by subdural hygroma should be considered. This warrants immediate MRI and emergent reoperation to relieve the pressure on the spinal cord may be necessary.

Primary Isolated Amyloidoma of the Lumbar Spine Causing Neurological Compromise: Case Report and Literature Review

Neurosurgery ◽  
2005 ◽  
Vol 57 (1) ◽  
pp. E196-E196 ◽  
Author(s):  
Avinash Haridas ◽  
Sunandan Basu ◽  
Andrew King ◽  
Jonathan Pollock
Keyword(s):  
Lumbar Spine ◽  
Clinical Presentation ◽  
Cauda Equina ◽  
Polarized Light ◽  
Good Prognosis ◽  
Left Knee ◽  
Lower Limbs ◽  
Magnetic Resonance Imaging Scan ◽  
Cauda Equina Compression ◽  
History Of

Abstract OBJECTIVE AND IMPORTANCE: We describe a patient with cauda equina compression secondary to amyloidoma to alert other clinicians to this rare cause of a compressive epidural lesion. It is the fourth published report of primary lumbar amyloidoma causing neurological compromise. CLINICAL PRESENTATION: A 53-year-old, previously fit salesman presented with several years history of back pain and recent weakness, especially in the left leg. He also had numbness and tingling radiating down the left leg. On examination, the left knee jerk was diminished, and both ankle jerks were absent. Power was reduced to 4/5 in ankle dorsiflexion bilaterally. A magnetic resonance imaging scan of the lumbar spine revealed an extradural mass, compressing the theca at L3–L4. This was enhancing in T1-weighted images and had low signal intensity in T2-weighted images. There was no evidence of systemic amyloidosis or development of multiple myeloma. INTERVENTION: L3–L4 laminectomy was performed, with removal of the epidural mass. The patient had complete resolution of sciatica and regained normal power in both lower limbs. There was no evidence of any recurrence at 1-year follow-up. CONCLUSION: Lumbar epidural amyloidoma is an extremely rare cause of cauda equina compression. Clinical presentation can be nonspecific, and radiologically, it can be indistinguishable from a tumor. Diagnosis is made at histological examination of a Congo red-stained section under polarized light. Complete resection of the localized epidural amyloid mass is associated with a good prognosis.

Iatrogenic intradural spinal arachnoid cyst as a complication of lumbar spine surgery

2009 ◽  
Vol 11 (3) ◽  
pp. 344-346 ◽  
Author(s):  
Eric W. Nottmeier ◽  
Robert E. Wharen ◽  
Naresh P. Patel
Keyword(s):  
Differential Diagnosis ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Arachnoid Cyst ◽  
Cauda Equina ◽  
Cyst Formation ◽  
Lumbar Spine Surgery ◽  
Lumbar Surgery ◽  
Spinal Arachnoid Cyst ◽  
Incidental Durotomy

Iatrogenic spinal arachnoid cysts are rare, but have been described as a complication of spinal injection and lumbar puncture procedures. The authors describe 2 cases of iatrogenic spinal arachnoid cyst formation that occurred after incidental durotomy during lumbar spine surgery. In both cases, postoperative MR imaging revealed compression of the cauda equina by an intradural arachnoid cyst. Intradural exploration and fenestration of the arachnoid cyst was accomplished in each case. This entity should be considered in the differential diagnosis of a patient experiencing symptoms of neurological compression after a lumbar surgery complicated by incidental durotomy.

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