Cauda Equina Syndrome

2018 ◽  
pp. 175-182
Author(s):  
Emily P. Sieg ◽  
Justin R. Davanzo ◽  
John P. Kelleher
Keyword(s):  
Lumbar Spine ◽  
Structural Damage ◽  
Cauda Equina ◽  
Sensory Function ◽  
Herniated Disc ◽  
Lumbosacral Spine ◽  
Common Cause ◽  
Bladder Control ◽  
Postsurgical Complications ◽  
Spine Mri

Cauda equine syndrome arises secondary to compression of or injury to the cauda equine, a group of nerves in the lumbosacral spine that provide motor and sensory function to most of the lower extremities, pelvic floor musculature, and sphincters. Symptoms can include loss of bowel and bladder control, lower extremity motor and sensory deficits, and pain. Compressive etiologies such as a midline herniated disc are the most common cause of cauda equine syndrome. Any patient with the described constellation of symptoms should undergo magnetic resonance imaging of the lumbar spine. In the setting of acute loss of motor, sensory, or autonomic function and a disc herniation or other compressive lesion seen on a lumbar spine MRI, emergency decompression via laminectomy should be undertaken. Complications range from structural damage intraoperatively to more general postsurgical complications. Operating on cauda equine patients at the earliest opportunity seems the most appropriate clinical practice.

scholarly journals Redundant Nerve Roots of the Cauda Equina, MRI Findings and Postoperative Clinical Outcome: Emphasizing an Overlooked Entity

2020 ◽  
pp. 219256822097537
Author(s):  
Liqa A. Rousan ◽  
Mamoon H. Al-Omari ◽  
Rasha M. Musleh ◽  
Mohammad I. Amir ◽  
Hajar El Kortbi ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Clinical Outcome ◽  
Strong Predictor ◽  
Cauda Equina ◽  
Decompression Surgery ◽  
Imaging Findings ◽  
Mri Findings ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Spine Mri

Study Design: Retrospective study. Objective: To describe the MRI findings of RNRs in patients with low back pain, and observe the imaging findings and the clinical outcome post decompression surgery. Methods: The lumbar spine MRI of 202 patients (122 females) with proven RNRs were retrospectively reviewed. The morphology and the location of the RNRs in relation to the level of stenosis were described. The level(s), grade and cause of lumbar canal stenosis were recorded. The persistence of symptoms and the imaging findings on follow up post decompression surgery were recorded. The imaging findings were correlated among each other and with patients’ demographics. Results: Two distinctive morphological appearance of the RNRs were noted: loop (56.4%), and serpentine-shaped. In the majority of the cases the RNRs were located above the level of stenosis (79.7%). Eighteen patients underwent decompression surgery, only 4 patients remained symptomatic post decompression surgery. The RNRs changed in shape and location after decompression surgery. Age was a strong predictor value in the location of the RNRs. There was no correlation between the shape and location of the RNRs, or with the gender of the patients. Conclusion: RNRs is not an uncommon finding on lumbar spine MRI with lumbar canal stenosis. Its importance remains a controversy. A common language between the radiologists and the clinicians is mandatory to aid in the management planning.

scholarly journals The Usefulness of Lumbar Spine MRI for Cauda Equina Syndrome

2011 ◽  
Vol 64 (5) ◽  
pp. 423
Author(s):  
Tae Yong Moon ◽  
Seung Kug Baik ◽  
In Sook Lee
Keyword(s):  
Lumbar Spine ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Spine Mri

scholarly journals Effect of the Intra-Abdominal Pressure and the Center of Segmental Body Mass on the Lumbar Spine Mechanics – A Computational Parametric Study

2012 ◽  
Vol 134 (1) ◽  
Author(s):  
W. M. Park ◽  
S. Wang ◽  
Y. H. Kim ◽  
K. B. Wood ◽  
J. A. Sim ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Computational Models ◽  
Muscle Force ◽  
Weight Bearing ◽  
Upper Body ◽  
Abdominal Pressure ◽  
Lumbosacral Spine ◽  
Simulation Accuracy ◽  
Joint Force ◽  
Geometric Center

Determination of physiological loads in human lumbar spine is critical for understanding the mechanisms of lumbar diseases and for designing surgical treatments. Computational models have been used widely to estimate the physiological loads of the spine during simulated functional activities. However, various assumptions on physiological factors such as the intra-abdominal pressure (IAP), centers of mass (COMs) of the upper body and lumbar segments, and vertebral centers of rotation (CORs) have been made in modeling techniques. Systematic knowledge of how these assumptions will affect the predicted spinal biomechanics is important for improving the simulation accuracy. In this paper, we developed a 3D subject-specific numerical model of the lumbosacral spine including T12 and 90 muscles. The effects of the IAP magnitude and COMs locations on the COR of each motion segment and on the joint/muscle forces were investigated using a global convergence optimization procedure when the subject was in a weight bearing standing position. The data indicated that the line connecting the CORs showed a smaller curvature than the lordosis of the lumbar spine in standing posture when the IAP was 0 kPa and the COMs were 10 mm anterior to the geometric center of the T12 vertebra. Increasing the IAP from 0 kPa to 10 kPa shifted the location of CORs toward the posterior direction (from 1.4 ± 8.9 mm anterior to intervertebral disc (IVD) centers to 40.5 ± 3.1 mm posterior to the IVD centers) and reduced the average joint force (from 0.78 ± 0.11 Body weight (BW) to 0.31 ± 0.07 BW) and overall muscle force (from 349.3 ± 57.7 N to 221.5 ± 84.2 N). Anterior movement of the COMs from −30 mm to 70 mm relative to the geometric center of T12 vertebra caused an anterior shift of the CORs (from 25.1 ± 8.3 mm posterior to IVD centers to 7.8 ± 6.2 mm anterior to IVD centers) and increases of average joint forces (from 0.78 ± 0.1 BW to 0.93 ± 0.1 BW) and muscle force (from 348.9 ± 47.7 N to 452.9 ± 58.6 N). Therefore, it is important to consider the IAP and correct COMs in order to accurately simulate human spine biomechanics. The method and results of this study could be useful for designing prevention strategies of spinal injuries and recurrences, and for enhancing rehabilitation efficiency.

Cauda Equina Syndrome in Patients Undergoing Manipulation of the Lumbar Spine

Spine ◽  
1992 ◽  
Vol 17 (12) ◽  
pp. 1469-1473 ◽  
Author(s):  
Scott Haldeman ◽  
Sidney M. Rubinstein
Keyword(s):  
Lumbar Spine ◽  
Cauda Equina Syndrome ◽  
Cauda Equina

The Effect of Computer-Assisted Reporting on Interreader Variability of Lumbar Spine MRI Degenerative Findings: Five Readers With 30 Disc Levels

2018 ◽  
Vol 15 (11) ◽  
pp. 1613-1619 ◽  
Author(s):  
Benjamin Wang ◽  
Daniel I. Rosenthal ◽  
Chun Xu ◽  
Pari V. Pandharipande ◽  
H. Benjamin Harvey ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Computer Assisted ◽  
Spine Mri

scholarly journals Osteopetrosis - A Case Series Exploring Complications and Multidisciplinary Management

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A209-A209
Author(s):  
Catherine Stewart ◽  
Paul Benjamin Loughrey ◽  
John R Lindsay
Keyword(s):  
Back Pain ◽  
Lumbar Spine ◽  
Medical History ◽  
Scaphoid Fracture ◽  
Past Medical History ◽  
Dxa Scan ◽  
X Ray ◽  
Management Of Complications ◽  
History Of ◽  
Spine Mri

Abstract Background: Osteopetrosis is a group of rare inherited skeletal dysplasias, with each variant sharing the hallmark of increased bone mineral density (BMD). Abnormal osteoclast activity produces overly dense bone predisposing to fracture and skeletal deformities. Whilst no cure for these disorders exists, endocrinologists play an important role in surveillance and management of complications. Clinical Cases: A 43-year-old female had findings suggestive of increased BMD on radiographic imaging performed to investigate shoulder and back pain. X-ray of lumbar spine demonstrated a ‘rugger jersey’ spine appearance, while shoulder X-ray revealed mixed lucency and sclerosis of the humeral head. DXA scan showed T-scores of +11 at the hip and +12.5 at the lumbar spine. MRI of head displayed bilateral narrowing and elongation of the internal acoustic meatus and narrowing of the orbital foramina. Genetic assessment confirmed autosomal dominant osteopetrosis with a CLCN7 variant. Oral colecalciferol supplementation was commenced and multi-disciplinary management instigated with referral to ophthalmology and ENT teams. A 25-year-old male presented with a seven-year history of low back pain and prominent bony swelling around the tibial tuberosities and nape of neck. Past medical history included repeated left scaphoid fracture in 2008 and 2018. Recovery from his scaphoid fracture was complicated by non-union requiring bone grafting with open reduction and fixation. Plain X-rays of the spine again demonstrated ‘rugger jersey’ spine. DXA scan was notable for elevated T scores; +2.9 at hip and +5.8 lumbar spine. MRI spine showed vertebral endplate cortical thickening and sclerosis at multiple levels. The patient declined genetic testing and is under clinical review. A 62-year-old male was referred to the bone metabolism service following a DXA scan showing T scores of +11. 7 at the hip and +13 at the lumbar spine. His primary complaint was of neck pain and on MRI there was multi-level nerve root impingement secondary to facet joint hypertrophy. Past medical history was significant for a long history of widespread joint pains; previous X-ray reports described generalized bony sclerosis up to 11 years previously. Clinical and radiological monitoring continues. Conclusion: Individuals with osteopetrosis require a multidisciplinary approach to management. There is no curative treatment and mainstay of therapy is supportive with active surveillance for complications.

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